Individual
MIWAKO OGUREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3509 DEWEY ST, MANITOWOC, WI 54220-5813
(920) 686-5731
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(920) 793-7000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
225200-30
WI
363L00000X
Nurse Practitioner
Primary
13817-33
WI
363LF0000X
Family Nurse Practitioner
13817-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100242248
—
WI
Enumeration date
02/03/2023
Last updated
11/19/2024
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