Individual
STEVEN MARK ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1511 TIFFANY ST, BOYCEVILLE, WI 54725-9543
(715) 643-2208
Mailing address
1511 TIFFANY ST, BOYCEVILLE, WI 54725-9543
(715) 643-2208
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
304080
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35015700
—
WI
Enumeration date
04/17/2007
Last updated
07/09/2007
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