Individual
DIANE M MANSFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2801 LOON LN, SAYNER, WI 54560-9665
(715) 542-4264
Mailing address
2801 LOON LN, SAYNER, WI 54560-9665
(715) 542-4264
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1925
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43950100
—
WI
Enumeration date
09/20/2006
Last updated
07/25/2013
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