Individual
MISS ROSA MEJIA PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
123 SHATO LN, MONONA, WI 53716-3795
(815) 238-3082
Mailing address
1410 WALNUT ST, APT 12, BARABOO, WI 53913-2903
(608) 844-3869
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
319425-31
WI
Other
Enumeration date
09/17/2015
Last updated
09/17/2015
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