Organization
WILLOW CREEK WOMENS CLINIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA FOSSUM RN FNPC APNP (OWNER)
(715) 832-9292
Entity
Organization
Contact information
Practice address
1470 RIVERS EDGE TRL STE 3, ALTOONA, WI 54720-2755
(715) 832-9292
(715) 832-4172
Mailing address
1470 RIVERS EDGE TRL STE 3, ALTOONA, WI 54720-2755
(715) 832-9292
(715) 832-4172
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
684 033 APNP
WI
363L00000X
Nurse Practitioner
Primary
85943 030 NP
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43898700
—
WI
Enumeration date
01/23/2007
Last updated
06/21/2024
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