Individual
PEGGY A EBBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
10 TRI PARK WAY, APPLETON, WI 54914-1658
(920) 831-0070
(920) 831-7939
Mailing address
N1139 JULIUS DR, GREENVILLE, WI 54942-8613
(920) 757-1991
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703042022
MI
Other
Enumeration date
07/16/2006
Last updated
07/08/2007
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