Individual
MARIAH ANTIGONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2000 FORDEM AVE, MADISON, WI 53704-4600
(608) 280-2700
Mailing address
25 KESSEL CT STE 105, MADISON, WI 53711-6227
(608) 280-2700
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
222717
WI
Other
Enumeration date
09/07/2022
Last updated
09/07/2022
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