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Individual

DANIELLE MARIE POLEGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
401 W MOHAWK DR, TOMAHAWK, WI 54487-2274
(715) 453-7700
Mailing address
401 W MOHAWK DR, TOMAHAWK, WI 54487-2274
(715) 453-7700

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
171656
WI
363LF0000X
Family Nurse Practitioner
Primary
9578-33
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
F07191563
AANP
WI
Enumeration date
07/23/2019
Last updated
11/20/2019
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