Individual
DANIELLE M MBIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1640 E SUMNER ST, HARTFORD, WI 53027-2684
(262) 670-4000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(262) 670-4000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
226012
WI
Other
Enumeration date
10/06/2023
Last updated
11/22/2023
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