Individual
C JEAN DITTMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
208 OGDEN AVE, APT 4, CLINTON, WI 53525-9036
(608) 676-6127
Mailing address
208 OGDEN AVE, APT 4, CLINTON, WI 53525-9036
(608) 676-6127
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
—
IL
164W00000X
Licensed Practical Nurse
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35043800
—
WI
Enumeration date
10/15/2007
Last updated
10/15/2007
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