Individual
ANGELA BOUTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
120 MEADOW LN, WEST SALEM, WI 54669-9263
(608) 385-4492
Mailing address
120 MEADOW LN, WEST SALEM, WI 54669-9263
(608) 385-4492
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
302098
WI
Other
Enumeration date
01/20/2022
Last updated
01/20/2022
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