Individual
MICHELLE LYNN PETRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
N56W34882 LAKE DR, OCONOMOWOC, WI 53066-2462
(262) 409-0863
Mailing address
N56W34882 LAKE DR, OCONOMOWOC, WI 53066-2462
(262) 409-0863
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
23025730
WI
Other
Enumeration date
11/08/2018
Last updated
11/08/2018
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