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Individual

DONNA J BANNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.N., BSN

Contact information

Practice address
961 AUTUMN RIDGE DR, OCONOMOWOC, WI 53066-4175
(262) 354-0465
Mailing address
961 AUTUMN RIDGE DR, OCONOMOWOC, WI 53066-4175
(262) 354-0465

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
195520-30
WI

Other

Enumeration date
06/18/2013
Last updated
06/18/2013
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