Individual
MRS. KATHLEEN MAE BUWALDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
W13546 MARSHVIEW RD, WAUPUN, WI 53963-9733
(920) 324-9948
Mailing address
W13546 MARSHVIEW RD, WAUPUN, WI 53963-9733
(920) 324-9948
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
303291-031
WI
Other
Enumeration date
04/13/2012
Last updated
04/13/2012
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