Individual
MRS. SHIRLEY TEMPLE GLADNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
4676 N 70TH ST, MILWAUKEE, WI 53218-4847
(414) 462-0802
Mailing address
4676 N 70TH ST, MILWAUKEE, WI 53218-4847
(414) 462-0802
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
91195-030
WI
163WC1500X
Community Health Registered Nurse
Primary
91195-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39957200
—
WI
Enumeration date
05/09/2008
Last updated
05/09/2008
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