Individual
MARY KAY BENOTSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
505 SOUTH WASHBURN STREET, OSHKOSH, WI 54904
(920) 232-2332
Mailing address
505 S WASHBURN ST, OSHKOSH, WI 54904-7949
(920) 232-2332
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
168085
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7754
—
WI
Enumeration date
09/13/2017
Last updated
07/21/2022
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