Individual
IRINA MUDRETS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4019 N 87TH ST, MILWAUKEE, WI 53222-1708
(414) 745-3053
(414) 357-6861
Mailing address
PO BOX 242183, MILWAUKEE, WI 53224-9045
(414) 745-3045
(414) 357-6861
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
305258-031
WI
Other
Enumeration date
07/31/2010
Last updated
07/31/2010
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