Individual
JOHN BRADLEY WAKEFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3600 TOWER AVE, SUPERIOR, WI 54880-5337
(715) 392-1955
(715) 392-1935
Mailing address
3600 TOWER AVE, SUPERIOR, WI 54880-5337
(715) 392-1955
(715) 392-1935
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
138615-30
WI
163W00000X
Registered Nurse
Primary
R 152778-6
MN
Other
Enumeration date
07/19/2006
Last updated
08/21/2012
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