Individual
FLORA MAE PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2092 S 102TH, APT 13 LUCINDA CORMWELL, WEST ALLIS, WI 53227
(414) 549-6899
Mailing address
4769 N 29 ST, MILWAUKEE, WI 53209
(414) 442-1780
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
16831031
WI
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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