Individual
PENNY ANN MOEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20 PRESTON DR, PLATTEVILLE, WI 53818-3017
(608) 778-2491
Mailing address
20 PRESTON DR, PLATTEVILLE, WI 53818-3017
(608) 778-2491
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
236128
WI
Other
Enumeration date
04/26/2019
Last updated
04/26/2019
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