Individual
STACEY LEE HAMRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
119 MERTON AVE, LODI, WI 53555-1424
(608) 592-0155
Mailing address
119 MERTON AVE, LODI, WI 53555-1424
(608) 592-0155
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
120989-030
WI
Other
Enumeration date
03/12/2011
Last updated
03/12/2011
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