Individual
AMY PUTNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3301 N BALLARD RD, SUITE B, APPLETON, WI 54911-8928
(920) 733-4443
Mailing address
3301 N BALLARD RD, SUITE B, APPLETON, WI 54911-8928
(920) 733-4443
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
190527
WI
Other
Enumeration date
06/30/2016
Last updated
06/30/2016
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