Individual
MARY KAIA HALVERSON-DURALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
910 FREMONT ST, UWSP HEALTH SERVICE, STEVENS POINT, WI 54481-3105
(715) 346-4646
Mailing address
1950 ASHFORD DR, PLOVER, WI 54467-3050
(715) 252-6999
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
995-023
WI
Other
Enumeration date
01/03/2007
Last updated
07/08/2007
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