Wise Woman Wellness Llc

NPI 1033447594 - Nurse Practitioner - 363LW0102X

NPI Details
NPI 1033447594
Enumeration Date 11/20/2009
Last Updated 11/20/2009
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name RANDI MARY RANDI
Position OWNER
Phone (920) 339-5252
Fax (920) 632-7652
Practice Location
1480 SWAN RD
DE PERE WI, 54115-7966, US
Phone (920) 339-5252
Fax (920) 632-7652
Business Location
1480 SWAN RD
DE PERE WI, 54115-7966, US
Phone (920) 339-5252
Fax (920) 632-7652
Toxanomy
Taxonomy Code 363LW0102X
License State Wisconsin
License Number 115-030
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According to our database, Wise Woman Wellness Llc NPI is 1033447594, taxonomy code is 363LW0102X and license number is 115-030, license state is located at Wisconsin. Wise Woman Wellness Llc physically located at 1480 Swan Rd, De Pere WI, 54115-7966. NPI Number 1033115704 has the healthcare provider type.

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1033447594 NPI number is provided on an as is basis without warranty of any kind. 1033447594 is maintained by the National Plan & Provider Enumeration System. The contents of Wise Woman Wellness Llc are for informational purposes only.