Individual
MRS. BARBARA BEAUDETTE BOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
N3995 ANNEX RD, JEFFERSON, WI 53549-9618
(920) 674-7105
Mailing address
N3995 ANNEX RD, JEFFERSON, WI 53549-9618
(920) 674-7105
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
62427-30
WI
363LF0000X
Family Nurse Practitioner
Primary
300-033
WI
Other
Enumeration date
02/22/2010
Last updated
02/22/2010
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