Individual
CHRISTEENA WAVE RITA EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1135 LIBERTY BLVD, SUN PRAIRIE, WI 53590-4407
(608) 906-1668
Mailing address
1135 LIBERTY BLVD, SUN PRAIRIE, WI 53590-4407
(608) 906-1668
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
304057-031
WI
Other
Enumeration date
04/06/2010
Last updated
04/06/2010
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