Individual
DIANE MARIE RUNDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
96 STODDART ST, BEAVER DAM, WI 53916-1306
(920) 885-3528
(920) 885-3662
Mailing address
PO BOX 731, BEAVER DAM, WI 53916-0731
(920) 885-3528
(920) 885-3662
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
3114-033
WI
Other
Enumeration date
03/26/2008
Last updated
04/14/2008
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