Provider Demographics
NPI:1871844639
Name:PALAY, NANETTE (APNP)
Entity type:Individual
Prefix:
First Name:NANETTE
Middle Name:
Last Name:PALAY
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 W MARKET ST STE 200
Mailing Address - Street 2:
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53092-5083
Mailing Address - Country:US
Mailing Address - Phone:262-241-5595
Mailing Address - Fax:262-241-5926
Practice Address - Street 1:1500 W MARKET ST STE 200
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-5083
Practice Address - Country:US
Practice Address - Phone:262-241-5595
Practice Address - Fax:262-241-5926
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4996-33363LP0808X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health