Individual
MRS. ELLEN L ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
N71W35536 MAPLETON LAKE DR, OCONOMOWOC, WI 53066-1214
(262) 352-4107
Mailing address
N71W35536 MAPLETON LAKE DR, OCONOMOWOC, WI 53066-1214
(262) 352-4107
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
170758-030
WI
Other
Enumeration date
04/19/2010
Last updated
09/27/2012
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