Individual
MRS. MACKENZIE RYAN PAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5735 DURAND AVE, MOUNT PLEASANT, WI 53406-5011
(262) 977-9488
Mailing address
1362 VINE ST, UNION GROVE, WI 53182-1507
(262) 221-0924
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
325707
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447859699
—
WI
Enumeration date
10/20/2020
Last updated
06/03/2022
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