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Individual

MANDY WALTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
N1691 WELSH RD, WATERTOWN, WI 53098-3759
(920) 206-1142
Mailing address
N1691 WELSH RD, WATERTOWN, WI 53098-3759
(920) 206-1142

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
144754-30
WI

Other

Enumeration date
09/08/2010
Last updated
09/08/2010
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