Individual
MARY ELIZABETH MASCARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
415 BLACK EARTH RD, WALES, WI 53183-9759
(630) 697-4034
Mailing address
1711 ELDER ST APT 204, WAUKESHA, WI 53188-3246
(262) 521-1921
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
324344-31
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407584675
—
WI
Enumeration date
08/15/2022
Last updated
08/15/2022
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