Individual
MRS. ROSE M. NEITZEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3400 HOLLYWOOD LN, BROOKFIELD, WI 53045-2508
(262) 781-9259
Mailing address
3400 HOLLYWOOD LN, BROOKFIELD, WI 53045-2508
(262) 781-9259
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
19521-031
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39860300
—
WI
Enumeration date
01/27/2007
Last updated
07/09/2007
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