Individual
MILLICENT JOANNA DOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
LAKE GENEVA 146 E GENEVA SQUARE, LAKE GENEVA, WI 53157
(262) 422-8038
Mailing address
W309S10910 COUNTY HWY I, MUKWONAGO, WI 53149
(262) 422-8038
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8165
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100075486
—
WI
Enumeration date
02/23/2018
Last updated
02/13/2024
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