Individual
MRS. MICHELE ANNE DREVNICK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.S., F-AAA
Contact information
Practice address
401 STAGELINE RD, SUITE 6, HUDSON, WI 54016-7897
(715) 531-6710
(715) 531-6711
Mailing address
401 STAGELINE RD, SUITE 6, HUDSON, WI 54016-7897
(715) 531-6710
(715) 531-6711
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
173-156
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41121100
—
WI
01
—
900174681012
BLUE CROSS BS WISCONSIN
WI
Enumeration date
07/07/2005
Last updated
07/09/2007
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