Individual
MS. SARAH JANE BOUC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3509 DEWEY ST, MANITOWOC, WI 54220-5813
(920) 686-5732
(920) 686-5726
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 389-2377
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
19724330
WI
363L00000X
Nurse Practitioner
Primary
9680-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100095376
—
WI
Enumeration date
09/13/2013
Last updated
11/24/2021
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