Individual
MARTINE BANDA-WOLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
333 E 2ND ST, RICHLAND CENTER, WI 53581-1914
(608) 647-6321
Mailing address
333 E 2ND ST, RICHLAND CENTER, WI 53581-1914
(608) 647-6321
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
302-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0852480001
DMERC
WI
05
—
43810800
—
WI
01
—
500010481
RAILROAD MEDICARE
WI
Enumeration date
08/09/2005
Last updated
08/14/2024
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