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Individual

CAROL J MOSEMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, RCS

Contact information

Practice address
1305 CAMELOT DR, JANESVILLE, WI 53548-1495
(608) 361-7053
Mailing address
3303 S AFTON RD, BELOIT, WI 53511-8749
(608) 365-4375

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
105320
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
38275500
STATE PROVIDER NUMBER
WI
Enumeration date
10/10/2006
Last updated
07/08/2007
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