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2621 S Oneida St Ste 104, Green Bay, WI 54304-5793 | |
| (920) 499-3511 | |
| Not Available |
| Full Name | |
|---|---|
| Type | Facility |
| Speciality | Eyewear Supplier |
| Location | 2621 S Oneida St Ste 104, Green Bay, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659937159 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
| Provider Name | Anne Marie C Laschen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588614549 PECOS PAC ID: 1850293952 Enrollment ID: I20040121000073 |
| Provider Name | Michelle M Mueller |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003867961 PECOS PAC ID: 3577465921 Enrollment ID: I20040126000080 |
| Provider Name | Jane A Manning |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205986197 PECOS PAC ID: 8628970951 Enrollment ID: I20040126000562 |
| Provider Name | Nicholas George Hafeman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114074416 PECOS PAC ID: 4486556750 Enrollment ID: I20040126000797 |
| Provider Name | Joseph P Romanak |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1275687105 PECOS PAC ID: 9133014699 Enrollment ID: I20040216000571 |
| Provider Name | Steven Laliberte |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467442582 PECOS PAC ID: 8224926829 Enrollment ID: I20040305000834 |
| Provider Name | Nicole L Amidon |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992762835 PECOS PAC ID: 4082698410 Enrollment ID: I20040621000041 |
| Provider Name | Lawrence W Smith |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1609828581 PECOS PAC ID: 1759359805 Enrollment ID: I20040917000236 |
| Provider Name | James F Dusenberry |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1871539619 PECOS PAC ID: 6406817436 Enrollment ID: I20041022001003 |
| Provider Name | April K Swim |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003838129 PECOS PAC ID: 0042276743 Enrollment ID: I20041204000111 |
| Provider Name | Kristie K Yeager |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1134209679 PECOS PAC ID: 7810946951 Enrollment ID: I20050117000063 |
| Provider Name | Lance E Engdahl |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1689730681 PECOS PAC ID: 3173572633 Enrollment ID: I20050121000660 |
| Provider Name | Julie A Oleary |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124110812 PECOS PAC ID: 4385690734 Enrollment ID: I20050329000471 |
| Provider Name | Kathryn A Korth |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1881646636 PECOS PAC ID: 3971540667 Enrollment ID: I20050414000142 |
| Provider Name | Nathan Paul Forst |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1043262322 PECOS PAC ID: 1052340171 Enrollment ID: I20050809000927 |
| Provider Name | Colleen N Konkel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1528018975 PECOS PAC ID: 4587693460 Enrollment ID: I20050810001195 |
| Provider Name | Michael Banwart |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1295838316 PECOS PAC ID: 7416927843 Enrollment ID: I20060227000246 |
| Provider Name | Richard R Toellner |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1881647030 PECOS PAC ID: 6901818848 Enrollment ID: I20060615000131 |
| Provider Name | Jennet R Shepherd |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1841242369 PECOS PAC ID: 5799797635 Enrollment ID: I20060615000155 |
| Provider Name | Amy Marie Peot |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1093767931 PECOS PAC ID: 4789696634 Enrollment ID: I20060615000164 |
| Provider Name | Lawrence R Johansen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1417908955 PECOS PAC ID: 7911919865 Enrollment ID: I20060615000204 |
| Provider Name | Kenneth Peter Thue |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1932151313 PECOS PAC ID: 3173535937 Enrollment ID: I20060615000311 |
| Provider Name | Heidi A Shufelt |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1447200456 PECOS PAC ID: 6800808668 Enrollment ID: I20060615000314 |
| Provider Name | James R Kriege |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1053368969 PECOS PAC ID: 0446262208 Enrollment ID: I20060615000319 |
| Provider Name | Donald George Lorentz |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1427008275 PECOS PAC ID: 3870505639 Enrollment ID: I20060615000331 |
| Provider Name | Eric Q Hanson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1679526958 PECOS PAC ID: 4688686447 Enrollment ID: I20060615000343 |
| Provider Name | Jean M Schemenauer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1851343479 PECOS PAC ID: 1951313717 Enrollment ID: I20060615000348 |
| Provider Name | Bret A Ammeraal |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104877398 PECOS PAC ID: 4587676242 Enrollment ID: I20060620000155 |
| Provider Name | Ron Mark Taub |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1881645612 PECOS PAC ID: 2769494426 Enrollment ID: I20060620000164 |
| Provider Name | Courtney Lee Okeefe |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1144271362 PECOS PAC ID: 8921010687 Enrollment ID: I20060620000176 |
| Provider Name | Kenneth Paul Martell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1386697613 PECOS PAC ID: 0749292407 Enrollment ID: I20060620000184 |
| Provider Name | Scott F Bruneau |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003868621 PECOS PAC ID: 2466464128 Enrollment ID: I20060620000192 |
| Provider Name | Timothy D Bevers |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1700837168 PECOS PAC ID: 5294747960 Enrollment ID: I20060620000256 |
| Provider Name | Theresa L Petrick Gatchell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285688192 PECOS PAC ID: 6002828787 Enrollment ID: I20060620000277 |
| Provider Name | Shannon M Macnab |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1275585119 PECOS PAC ID: 5092727776 Enrollment ID: I20060620000288 |
| Provider Name | Brian F Cook |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1316991698 PECOS PAC ID: 6800808585 Enrollment ID: I20060620000296 |
| Provider Name | Bryan C Gironella |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1558311217 PECOS PAC ID: 4385656990 Enrollment ID: I20060623000248 |
| Provider Name | Marc P Frederiksen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1770534554 PECOS PAC ID: 2163434663 Enrollment ID: I20060628000029 |
| Provider Name | Brian L Schroedl |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1255387684 PECOS PAC ID: 2769495639 Enrollment ID: I20060718000236 |
| Provider Name | James W Wallace |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285675827 PECOS PAC ID: 9830102706 Enrollment ID: I20060718000251 |
| Provider Name | Steven Neyens |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811947476 PECOS PAC ID: 8820001795 Enrollment ID: I20060718000260 |
| Provider Name | James L Schmonsky |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1609896042 PECOS PAC ID: 5395744494 Enrollment ID: I20061219000526 |
| Provider Name | Deanne K Funkhouser |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1912126202 PECOS PAC ID: 3072606573 Enrollment ID: I20070829000360 |
| Provider Name | Jamie L Ertl |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1952392003 PECOS PAC ID: 9739269481 Enrollment ID: I20080107000790 |
| Provider Name | Busisiwe R Vandriel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1043403967 PECOS PAC ID: 2769562164 Enrollment ID: I20080110000061 |
| Provider Name | Mary Jo Byers |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1700938867 PECOS PAC ID: 4789768383 Enrollment ID: I20080225000139 |
| Provider Name | Joseph J Krupka |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1407966658 PECOS PAC ID: 5193809010 Enrollment ID: I20080229000538 |
| Provider Name | Stephen R Rollins |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1235125436 PECOS PAC ID: 0648349019 Enrollment ID: I20080527000636 |
| Provider Name | Kyle J Klika |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205090990 PECOS PAC ID: 0840366928 Enrollment ID: I20080915000330 |
| Provider Name | Jennifer Gipp |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1154520666 PECOS PAC ID: 8729189899 Enrollment ID: I20090728000141 |
| Provider Name | Christine A Ward |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1013145952 PECOS PAC ID: 1759421704 Enrollment ID: I20091223000015 |
| Provider Name | Stephen Sternitzky |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1790768968 PECOS PAC ID: 3971628736 Enrollment ID: I20100916000710 |
| Provider Name | Laura J Rau |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1013994524 PECOS PAC ID: 1355534876 Enrollment ID: I20101015001301 |
| Provider Name | Timothy J Frederiksen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1649262478 PECOS PAC ID: 4284841958 Enrollment ID: I20101119001206 |
| Provider Name | Wesley R Meyer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1396714812 PECOS PAC ID: 0244324390 Enrollment ID: I20110114000618 |
| Provider Name | Cynthia Malvitz Overly |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1457498602 PECOS PAC ID: 0143336024 Enrollment ID: I20110217000536 |
| Provider Name | Megan M Draper |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1780791194 PECOS PAC ID: 3577563055 Enrollment ID: I20110714000696 |
| Provider Name | Amanda E Jolly |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1396031951 PECOS PAC ID: 9335316967 Enrollment ID: I20120121000047 |
| Provider Name | Erika R Mish |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1912105255 PECOS PAC ID: 5294997540 Enrollment ID: I20120502000350 |
| Provider Name | Catherine A Loughrin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1336435445 PECOS PAC ID: 9133383680 Enrollment ID: I20120613000025 |
| Provider Name | Erin R Daggett |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1215342084 PECOS PAC ID: 3678791597 Enrollment ID: I20140905001097 |
| Provider Name | Chad R Slagle |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1093157992 PECOS PAC ID: 2567786650 Enrollment ID: I20150120001976 |
| Provider Name | Paul Kappell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1376783621 PECOS PAC ID: 3072839489 Enrollment ID: I20150309002662 |
| Provider Name | David J Slagowski |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1356393623 PECOS PAC ID: 3375571326 Enrollment ID: I20170201002130 |
| Provider Name | Robert L Meyer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1942721204 PECOS PAC ID: 1254603772 Enrollment ID: I20170818000007 |
| Provider Name | Nicole J Klotzbuecher |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1134641848 PECOS PAC ID: 0143592501 Enrollment ID: I20170818002102 |
| Provider Name | Sean M Sarazen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1790217503 PECOS PAC ID: 0345512257 Enrollment ID: I20170826000165 |
| Provider Name | Alicja J Fitzgerald |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124341375 PECOS PAC ID: 4789841396 Enrollment ID: I20171009001032 |
| Provider Name | Nicholas J Roovers |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1457843161 PECOS PAC ID: 6103173893 Enrollment ID: I20180726001944 |
| Provider Name | Scott K Forsythe |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1295216943 PECOS PAC ID: 5597018028 Enrollment ID: I20181030001103 |
| Provider Name | Brianne Herlitzke |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992268551 PECOS PAC ID: 8022342229 Enrollment ID: I20190621001269 |
| Provider Name | Zachary James Shriver |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1841852464 PECOS PAC ID: 1254666969 Enrollment ID: I20190717000603 |
| Provider Name | Heidi A Przislicki |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1558921197 PECOS PAC ID: 8224366208 Enrollment ID: I20190829000675 |
| Provider Name | Maureen Finley Arthurs |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1780830984 PECOS PAC ID: 7416073895 Enrollment ID: I20191126001760 |
| Provider Name | David M Turner |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588077473 PECOS PAC ID: 6305064718 Enrollment ID: I20200204000624 |
| Provider Name | Jennifer Caine |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205067139 PECOS PAC ID: 7618123829 Enrollment ID: I20200310001459 |
| Provider Name | Steven Michael Mccarty |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1629636105 PECOS PAC ID: 7012346745 Enrollment ID: I20200401001670 |
| Provider Name | Krista Kay King |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1497884423 PECOS PAC ID: 6608297155 Enrollment ID: I20200609001366 |
| Provider Name | Nicole Shirley Avgoulas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831714120 PECOS PAC ID: 4082037437 Enrollment ID: I20200702000675 |
| Provider Name | Noel Arackal |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1477179349 PECOS PAC ID: 5597188813 Enrollment ID: I20200706000965 |
| Provider Name | Seth Arden Manke |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1174147219 PECOS PAC ID: 1850714189 Enrollment ID: I20200706001026 |
| Provider Name | Michael Joseph Bannon |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124645585 PECOS PAC ID: 8426474859 Enrollment ID: I20200817001762 |
| Provider Name | Stephanie Golon |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205451762 PECOS PAC ID: 1557787595 Enrollment ID: I20200820001958 |
| Provider Name | Alyssa Chrisman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1487278479 PECOS PAC ID: 7416375654 Enrollment ID: I20200921000312 |
| Provider Name | Thomas Sczepanski |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1669570461 PECOS PAC ID: 9436382082 Enrollment ID: I20201223000180 |
| Provider Name | Jessica Smith |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1922537653 PECOS PAC ID: 0042561649 Enrollment ID: I20210311001934 |
| Provider Name | Richard E Sofinski |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1184847386 PECOS PAC ID: 9436333515 Enrollment ID: I20210317000457 |
| Provider Name | Stephanie D'orazio-brafman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811372279 PECOS PAC ID: 6406156678 Enrollment ID: I20210630002757 |
| Provider Name | Jennafer Jane Ziemer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1700550886 PECOS PAC ID: 6305241845 Enrollment ID: I20210823001267 |
| Provider Name | Pamela Marie Marzec |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1134472996 PECOS PAC ID: 5092958942 Enrollment ID: I20210907000767 |
| Provider Name | Deanna Ippolito |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1225683121 PECOS PAC ID: 8426388257 Enrollment ID: I20210907003567 |
| Provider Name | Candace Christen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811036056 PECOS PAC ID: 6204886427 Enrollment ID: I20210908001593 |
| Provider Name | Jonathon David Connors |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003463944 PECOS PAC ID: 1658778303 Enrollment ID: I20210922001572 |
| Provider Name | Jacqueline Carmen Elizabeth Evans |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1053726315 PECOS PAC ID: 4587997473 Enrollment ID: I20210923003272 |
| Provider Name | Pranaya Bista |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124792411 PECOS PAC ID: 2769889393 Enrollment ID: I20210924001767 |
| Provider Name | Megan Sales |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1760151120 PECOS PAC ID: 5698172013 Enrollment ID: I20210927002648 |
| Provider Name | Teresa Pham |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1376685966 PECOS PAC ID: 7214249309 Enrollment ID: I20211001001438 |
| Provider Name | Brian Anderson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1356436661 PECOS PAC ID: 1759316631 Enrollment ID: I20211012001166 |
| Provider Name | Taylor Davis |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1306411731 PECOS PAC ID: 4183024763 Enrollment ID: I20211012002921 |
| Provider Name | Christine Luzuriaga |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1538470083 PECOS PAC ID: 5294912788 Enrollment ID: I20211014000410 |
| Provider Name | Tiffany Marcoe |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1083182950 PECOS PAC ID: 8921347303 Enrollment ID: I20211014000949 |
| Provider Name | Saadi Darvish |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003822834 PECOS PAC ID: 4688847478 Enrollment ID: I20211015000393 |
| Provider Name | Christine Kantor |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1235145764 PECOS PAC ID: 6103821921 Enrollment ID: I20211018002826 |
| Provider Name | Nayab Davis |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1942782321 PECOS PAC ID: 0547512030 Enrollment ID: I20211028000089 |
| Provider Name | Philip Potts |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1952449837 PECOS PAC ID: 3375648660 Enrollment ID: I20211101002105 |
| Provider Name | Michelle Williams |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1346389459 PECOS PAC ID: 5294763496 Enrollment ID: I20211103002313 |
| Provider Name | Van-anh Huynh |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1770036212 PECOS PAC ID: 4688072622 Enrollment ID: I20211103002363 |
| Provider Name | Karen Mohar Sanghera |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467884817 PECOS PAC ID: 0446477798 Enrollment ID: I20211103002689 |
| Provider Name | Cassandra Lappegaard |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1962742627 PECOS PAC ID: 3779727995 Enrollment ID: I20211104000515 |
| Provider Name | Jared Grant |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1821472267 PECOS PAC ID: 7517261829 Enrollment ID: I20211105000424 |
| Provider Name | Leann Goslak |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205915451 PECOS PAC ID: 0840473484 Enrollment ID: I20211105001996 |
| Provider Name | Jenny Michelle Soo Hoo |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124401427 PECOS PAC ID: 1850605767 Enrollment ID: I20211119001891 |
| Provider Name | Stephanie Corbin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124545603 PECOS PAC ID: 6406113760 Enrollment ID: I20211208000217 |
| Provider Name | Bradley Habermehl |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1356375463 PECOS PAC ID: 2365443314 Enrollment ID: I20220207001359 |
| Provider Name | Jamie Elmore |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467008680 PECOS PAC ID: 9638562937 Enrollment ID: I20220209001883 |
| Provider Name | Malay Pansheria |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1821471657 PECOS PAC ID: 4082904214 Enrollment ID: I20220322002277 |
| Provider Name | Colleen Patricia Hennelly |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1316159742 PECOS PAC ID: 1355738287 Enrollment ID: I20220425000935 |
| Provider Name | Tara Elizabeth-marie Hoppe |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1164164794 PECOS PAC ID: 7214324771 Enrollment ID: I20220502001046 |
| Provider Name | Haley Elise Brown |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1346868809 PECOS PAC ID: 9335528496 Enrollment ID: I20220620001515 |
| Provider Name | Steven Ticknor |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1174260715 PECOS PAC ID: 6002290202 Enrollment ID: I20220908000112 |
| Provider Name | Bryce Boente |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1619604972 PECOS PAC ID: 1850774134 Enrollment ID: I20220909001202 |
| Provider Name | Tanner Nichole Taylor |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1316674625 PECOS PAC ID: 8123403508 Enrollment ID: I20220921001889 |
| Provider Name | Leah Kirkemier |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1295838548 PECOS PAC ID: 9638276363 Enrollment ID: I20221107002010 |
| Provider Name | Jake Jochimsen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1639886567 PECOS PAC ID: 9436527850 Enrollment ID: I20221116000957 |
| Provider Name | Brittany Konwinski |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740997162 PECOS PAC ID: 3173991288 Enrollment ID: I20221122000199 |
| Provider Name | Sheryl Reaves |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1023301280 PECOS PAC ID: 7315194826 Enrollment ID: I20221205001104 |
| Provider Name | Nicholas Barlas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1346919743 PECOS PAC ID: 3779953187 Enrollment ID: I20221229001969 |
| Provider Name | Douglas Herriott |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1700885860 PECOS PAC ID: 4486793072 Enrollment ID: I20221230000376 |
| Provider Name | Claudine Jackson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1659388114 PECOS PAC ID: 9931537776 Enrollment ID: I20221230000737 |
| Provider Name | Vlada Straton |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831296151 PECOS PAC ID: 2466578760 Enrollment ID: I20230119001907 |
| Provider Name | Kristin Baragona |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114507092 PECOS PAC ID: 0941602056 Enrollment ID: I20230120001379 |
| Provider Name | Alison Atchison |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285921296 PECOS PAC ID: 6002084233 Enrollment ID: I20230120001881 |
| Provider Name | Tania Malara |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003966839 PECOS PAC ID: 6507965589 Enrollment ID: I20230123001344 |
| Provider Name | My Phuong Bui |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831544295 PECOS PAC ID: 0840586400 Enrollment ID: I20230215001536 |
| Provider Name | Vrajika Patel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588282156 PECOS PAC ID: 7315362217 Enrollment ID: I20230302002926 |
| Provider Name | Dana Hobi |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1619590403 PECOS PAC ID: 3779966551 Enrollment ID: I20230303001980 |
| Provider Name | Thuy Nguyen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811517899 PECOS PAC ID: 9537567003 Enrollment ID: I20230418002147 |
| Provider Name | Michael Phillips |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811993694 PECOS PAC ID: 5890828727 Enrollment ID: I20230419000520 |
| Provider Name | Blaze Sammon |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1093442121 PECOS PAC ID: 8729443551 Enrollment ID: I20230502000056 |
| Provider Name | Cole Barnhart |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285326975 PECOS PAC ID: 4082071048 Enrollment ID: I20230606002785 |
| Provider Name | James F Adams |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1154007953 PECOS PAC ID: 0840651733 Enrollment ID: I20230725000873 |
| Provider Name | Nathan Michael Larson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073207445 PECOS PAC ID: 8022479815 Enrollment ID: I20230726001475 |
| Provider Name | Mikolaj Nowobilski |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285319020 PECOS PAC ID: 9335500164 Enrollment ID: I20230726003216 |
| Provider Name | Tesia Reed |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104388800 PECOS PAC ID: 4981023124 Enrollment ID: I20230727002237 |
| Provider Name | Fatima Karim |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1538545611 PECOS PAC ID: 1850641333 Enrollment ID: I20230828002731 |
| Provider Name | Sheila Bogart |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1902859812 PECOS PAC ID: 8527166305 Enrollment ID: I20231031001179 |
| Provider Name | Mary Ference |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073734224 PECOS PAC ID: 4880580703 Enrollment ID: I20231108000437 |
| Provider Name | Prarthana Agrawal |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1013355288 PECOS PAC ID: 6103104195 Enrollment ID: I20231116000917 |
| Provider Name | Berta Newton |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124540083 PECOS PAC ID: 9032526512 Enrollment ID: I20240207001575 |
| Provider Name | Andria Pihos |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1013900422 PECOS PAC ID: 4183750904 Enrollment ID: I20240306000373 |
| Provider Name | Courtney Lynn Luce |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1326782244 PECOS PAC ID: 3678955663 Enrollment ID: I20240306000474 |
| Provider Name | Kathryn Hohs |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1902393143 PECOS PAC ID: 4789931619 Enrollment ID: I20240306000877 |
| Provider Name | Navjit Sanghera |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1033143078 PECOS PAC ID: 7618980129 Enrollment ID: I20240306002062 |
| Provider Name | Samantha Dodda |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104443720 PECOS PAC ID: 1052734464 Enrollment ID: I20240306003386 |
| Provider Name | Julia Lilly |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1730921024 PECOS PAC ID: 3577007327 Enrollment ID: I20240703001823 |
| Provider Name | Amber Nicole Denell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1306684956 PECOS PAC ID: 0547707564 Enrollment ID: I20240807003107 |
| Provider Name | Courtney Handzel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1477381200 PECOS PAC ID: 6406395243 Enrollment ID: I20240826000925 |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 19060, Green Bay, WI 54307-9060 Ph: () - | 2621 S Oneida St Ste 104, Green Bay, WI 54304-5793 Ph: (920) 499-3511 |