Individual
MS. TERESA M HUMPHREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
4611 N MORRIS BLVD, SHOREWOOD, WI 53211-1121
(414) 243-9851
(262) 548-8084
Mailing address
4611 N MORRIS BLVD, SHOREWOOD, WI 53211-1121
(414) 243-9851
(262) 548-8084
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
91497-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39863800
—
WI
Enumeration date
01/30/2008
Last updated
01/30/2008
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