Individual
TRUDY A MARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1700 TUTTLE ST, BARABOO, WI 53913-3319
(608) 356-2145
(608) 356-2147
Mailing address
1700 TUTTLE ST, BARABOO, WI 53913-3319
(608) 356-2145
(608) 356-2147
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
994
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558326967
—
WI
Enumeration date
04/19/2006
Last updated
12/10/2020
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