Individual
NICOLE MARIE BOUWMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1717 S 70TH, WEST ALLIS, WI 53214
(414) 791-2031
Mailing address
3657 S 18TH ST, MILWAUKEE, WI 53221-1551
(414) 517-4059
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38325200
—
WI
Enumeration date
03/26/2007
Last updated
07/09/2007
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