Individual
KRYSTAL J BOARDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNNP
Contact information
Practice address
2402 WINNEBAGO ST, MADISON, WI 53704-5341
(608) 287-2832
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3150-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36036100
—
WI
01
—
60709
DEAN HEALTH INSURANCE
WI
Enumeration date
06/25/2007
Last updated
02/17/2021
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