Individual
BETH FAHLBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 HIGHLAND AVE, CSC K6/316, MADISON, WI 53792-2455
(608) 338-8935
Mailing address
600 HIGHLAND AVE, CSC K6/316, MADISON, WI 53792-2455
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
158869-30
WI
Other
Enumeration date
10/29/2010
Last updated
10/29/2010
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