Individual
TERESA M PULVERMACHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
230 PINE ST, LA CROSSE, WI 54601-3481
(608) 668-2103
(833) 997-3923
Mailing address
333 FRONT ST N, LA CROSSE, WI 54601-3220
(608) 668-2103
(833) 997-3923
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
116838
WI
363L00000X
Nurse Practitioner
Primary
4305
WI
363LF0000X
Family Nurse Practitioner
4305-33
WI
Other
Enumeration date
05/11/2011
Last updated
10/30/2023
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