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Individual

LOU ANN MOKWA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP

Contact information

Practice address
1818 N MEADE ST, APPLETON, WI 54911-3454
(920) 731-8900
(920) 738-5369
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
(920) 996-3200
(920) 738-5787

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
3830
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
450030638
MEDICARE PTCAN
WI
01
711290059
MEDICARE PTCAN
WI
01
WI2257028
MEDICARE PTCAN
WI
Enumeration date
09/08/2009
Last updated
09/05/2012
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