Individual
PAUL JOSEPH BASTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
1209 N 8TH AVE, STURGEON BAY, WI 54235-1190
(920) 495-4837
Mailing address
1209 N 8TH AVE, STURGEON BAY, WI 54235-1190
(920) 495-4837
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
190769-30
WI
Other
Enumeration date
09/17/2012
Last updated
09/17/2012
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