Individual
PRECIOUS MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
8207 22ND AVE, KENOSHA, WI 53143-6206
(224) 610-8913
Mailing address
806 MUIR AVE, LAKE BLUFF, IL 60044-1534
(773) 396-7155
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
041455745
IL
Other
Enumeration date
04/14/2023
Last updated
04/14/2023
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