Individual
DESIREE JEAN MANCL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1110 WILLIAMSON ST APT 1, MADISON, WI 53703-4667
(715) 252-5448
Mailing address
285 N THOMPSON DR, MADISON, WI 53714-2069
(715) 252-5448
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
191530-30
WI
Other
Enumeration date
03/28/2013
Last updated
03/28/2013
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