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Individual

SALLY JO MARIE IVERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
10369 STATE HWY 27, HAYWARD, WI 54843
(715) 934-5454
Mailing address
10369 ST HWY 27, HAYWARD, WI 54843
(715) 934-5454

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
305181-31
WI

Other

Enumeration date
03/31/2026
Last updated
03/31/2026
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