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Individual

JOYCE ELAINE LEIS

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
704 WALNUT ST, BOSCOBEL, WI 53805-1360
(608) 375-4229
Mailing address
704 WALNUT ST, BOSCOBEL, WI 53805-1360
(608) 375-4229

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
38323600
PN
WI
Enumeration date
04/26/2006
Last updated
07/08/2007
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