Individual
MS. STACY CARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3995 S 92ND ST, GREENFIELD, WI 53228-2100
(414) 918-2313
Mailing address
3995 S 92ND ST, GREENFIELD, WI 53228-2100
(414) 918-2313
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
304585-031
WI
Other
Enumeration date
09/21/2012
Last updated
09/21/2012
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