Individual
MRS. CAROL GALE HALVORSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
5121 SMEJKAL RD, STURGEON BAY, WI 54235-9111
(630) 745-8416
Mailing address
5121 SMEJKAL RD, STURGEON BAY, WI 54235-9111
(630) 745-8416
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
312130-031
WI
Other
Enumeration date
01/19/2010
Last updated
01/19/2010
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