Individual
MARY B KLONECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
625 W MAIN ST, ARCADIA, WI 54612-1227
(608) 323-3210
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2036302
MN
363LF0000X
Family Nurse Practitioner
203630-2
MN
363LF0000X
Family Nurse Practitioner
Primary
5228
WI
Other
Enumeration date
09/14/2011
Last updated
07/21/2022
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