Individual
MELISSA MARIE WASMUND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1715 WALBURG RD, BURLINGTON, WI 53105-8605
(262) 492-6825
Mailing address
1715 WALBURG RD., BURLINGTON, WI 53105
(262) 492-6825
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
190320-30
WI
164W00000X
Licensed Practical Nurse
313846-031
WI
Other
Enumeration date
04/16/2012
Last updated
06/15/2012
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