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Individual

MRS. PAMELA SUE BRUCKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
W7755 CTY RD V, CASCADE, WI 53011-1234
(920) 528-8198
(920) 528-7056
Mailing address
W 7755 CTY. RD. V, CASCADE, WI 53011-1234
(920) 528-8198
(920) 528-7056

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
14165-031
WI

Other

Enumeration date
12/23/2008
Last updated
12/23/2008
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