Individual
TRACI L BULOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
501 N WISCONSIN ST, ELKHORN, WI 53121-1118
(262) 723-7736
Mailing address
501 N WISCONSIN ST, ELKHORN, WI 53121-1118
(262) 723-7736
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
162541-030
WI
Other
Enumeration date
04/21/2011
Last updated
04/21/2011
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