Individual
SHOUA HER VANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5016 N MARY MARTIN DR, APPLETON, WI 54913-8061
(920) 850-0264
Mailing address
5016 N MARY MARTIN DR, APPLETON, WI 54913-8061
(920) 850-0264
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
200164-30
WI
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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