Individual
MARCIA WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
10 TRI PARK WAY, APPLETON, WI 54914-1658
(920) 831-0070
Mailing address
404 E 17TH ST, KAUKAUNA, WI 54130-3360
(920) 766-5682
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
10833-031
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10833-031
LICENSED PRACTICAL NURSE
WI
Enumeration date
07/26/2006
Last updated
07/08/2007
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