Individual
PAYOLA HER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1287 GLANE CT, OSHKOSH, WI 54902-9188
(920) 456-9740
Mailing address
1287 GLANE CT, OSHKOSH, WI 54902-9188
(920) 456-9740
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
226310
WI
Other
Enumeration date
01/06/2018
Last updated
06/11/2019
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