NATHAN WALLENFANG Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209020256

License Status

ACTIVE

Business

First Name

NATHAN

Last Name

WALLENFANG

Business Name

NATHAN WALLENFANG

Original Issue Date

10/19/2019

Effective Date

05/16/2024

Expiration Date

05/31/2026

City

GREEN BAY

State

Zip

54311

Ever Disciplined

LastModifiedDate

03/02/2026