Individual
MRS. LANICE MCDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5735 DURAND AVE STE A, MOUNT PLEASANT, WI 53406-5011
(262) 598-1392
Mailing address
5735 DURAND AVE STE A, MOUNT PLEASANT, WI 53406-5011
(262) 598-1392
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
319834-31
WI
Other
Enumeration date
11/10/2015
Last updated
11/10/2015
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