Individual
FAITH IBU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
700 WEST AVE S, LA CROSSE, WI 54601-4783
(608) 785-0940
Mailing address
PO BOX 860912, MINNEAPOLIS, MN 55486-0912
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2022023472
MO
207P00000X
Emergency Medicine Physician
79922
MN
207P00000X
Emergency Medicine Physician
Primary
86599
WI
Other
Enumeration date
06/27/2022
Last updated
06/30/2026
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