Organization
PRIVATE DUTY NURSING SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUSTAPHA KAMBI RN (REGISTERED)
(231) 343-8538
Entity
Organization
Contact information
Practice address
1538 TROY DR APT 1, MADISON, WI 53704-2074
(231) 343-8538
Mailing address
1538 TROY DR APT 1, MADISON, WI 53704-2074
(231) 343-8538
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
19433930
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2241974
—
WI
Enumeration date
08/19/2013
Last updated
08/20/2013
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