Organization
JUDITH C. MANN RN INDEPENDENT NURSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDITH C. MANN RN BSN (RN)
(920) 623-3449
Entity
Organization
Contact information
Practice address
W987 HALL RD, COLUMBUS, WI 53925-9509
(920) 623-3449
(920) 623-3742
Mailing address
W987 HALL RD, COLUMBUS, WI 53925-9509
(920) 623-3449
(920) 623-3742
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
78528-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40002800
PROVIDER # MEDICAID
WI
Enumeration date
03/16/2006
Last updated
07/08/2008
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