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Individual

MISS SAMANTHA LYNN BOTHWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
3244 W VERA AVE, MILWAUKEE, WI 53209-2518
(262) 370-1397
Mailing address
3244 W VERA AVE, MILWAUKEE, WI 53209-2518
(262) 370-1397

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
168738-30
WI

Other

Enumeration date
04/22/2014
Last updated
04/22/2014
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