Individual
MARY FOURNESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.P.N.P.
Contact information
Practice address
717 W MORELAND BLVD, PROHEALTH CARE MEDICAL ASSOCIATES MORELAND FAMILY MEDIC, WAUKESHA, WI 53188-2432
(262) 542-9100
(262) 542-7366
Mailing address
717 W MORELAND BLVD, PROHEALTH CARE MEDICAL ASSOCIATES MORELAND FAMILY MEDIC, WAUKESHA, WI 53188-2432
(262) 542-9100
(262) 542-7366
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1754033
WI
Other
Enumeration date
02/16/2007
Last updated
08/01/2013
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