Individual
MRS. MARY KATHLEEN BORNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICENSE PRACTICAL NU
Contact information
Practice address
W. 6143 N. THORNAPPLE COURT, FORT ATKINSON, WI 53538
(920) 563-2359
Mailing address
W. 6143 N. THORNAPPLE COURT, FORT ATKINSON, WI 53538
(920) 563-2359
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
13474-031
WI
Other
Enumeration date
04/30/2009
Last updated
04/30/2009
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