Individual
JUDITH A. BAGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1 MAIN ST, RACINE, WI 53403-1079
(262) 687-6100
(262) 687-2727
Mailing address
1 MAIN ST, RACINE, WI 53403-1079
(262) 687-6100
(262) 687-2727
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
458
WI
Other
Enumeration date
07/10/2006
Last updated
08/12/2010
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