Individual
RENEE MIKONOWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1900 N DEWEY AVE, REEDSBURG, WI 53959-2214
(608) 524-6477
Mailing address
1900 N DEWEY AVE, REEDSBURG, WI 53959-2214
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
130420
WI
363L00000X
Nurse Practitioner
Primary
2259
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43986900
—
WI
Enumeration date
09/29/2005
Last updated
07/27/2023
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