Individual
MICKEY PEASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
298 N 7TH ST, TRAILER # 9, MUSCODA, WI 53573-9211
(608) 604-7890
Mailing address
PO BOX 676, MUSCODA, WI 53573-0676
(608) 604-7890
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
135964-30
WI
Other
Enumeration date
04/15/2016
Last updated
04/15/2016
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