Individual
ALYCEA NOEL PUPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
5302 FULLER ST, WESTON, WI 54476-3101
(715) 219-8950
(715) 692-0246
Mailing address
5302 FULLER ST, WESTON, WI 54476-3101
(715) 219-8950
(715) 692-0246
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
6153-33
WI
363LF0000X
Family Nurse Practitioner
Primary
6153
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160594
RN LICENSE
WI
Enumeration date
12/19/2014
Last updated
03/27/2022
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