Individual
DEANNA MARIE HALVORSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
123 SHATO LN, MONONA, WI 53716-3795
(608) 415-8822
Mailing address
E8062 KLEIN RD, NORTH FREEDOM, WI 53951-9617
(608) 415-8822
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
178841-30
WI
Other
Enumeration date
02/11/2020
Last updated
02/11/2020
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