Individual
COLLEEN ANNE RICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1138 BLUE DAHLIA RD, OCONOMOWOC, WI 53066-2202
(262) 720-6722
Mailing address
1138 BLUE DAHLIA RD, OCONOMOWOC, WI 53066-2202
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
134742-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R200-1015-6827-08
DL
WI
Enumeration date
09/11/2017
Last updated
09/11/2017
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