Individual
MRS. STEPHANIE MICHELLE MUNDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
N68W35460 COUNTY ROAD K, OCONOMOWOC, WI 53066-1210
(262) 966-2702
Mailing address
PO BOX 444, WAUKESHA, WI 53187-0444
(262) 271-2141
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
311978-031
WI
Other
Enumeration date
12/07/2010
Last updated
12/07/2010
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