Individual
AMY DENNEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
W10237 LAKE EMILY RD, FOX LAKE, WI 53933
(920) 928-6960
Mailing address
226 E MONROE AVE, HARTFORD, WI 53027-2416
(414) 617-0724
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9767
WI
Other
Enumeration date
12/06/2019
Last updated
12/06/2019
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