Individual
MARY P GOSPODAREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
2219 GARFIELD ST, TWO RIVERS, WI 54241
(920) 793-2281
Mailing address
2219 GARFIELD ST, TWO RIVERS, WI 54241-2416
(920) 793-2281
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1539
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43904900
—
WI
Enumeration date
06/05/2006
Last updated
11/22/2021
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