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Organization

SOUTHWESTERN WI COMMUNTY ACTION PROGRAM

Active
Other names
SWCAP Neighborhood Health Partners
Organization subpart
No

Provider details

NPI number
Authorized official
JACQUELYNE ANNE BODDEN NP (PROGRAM DIRECTOR/NURSE PRACTITIONER)
(608) 348-9766
Entity
Organization

Contact information

Practice address
275 W MAIN ST, PLATTEVILLE, WI 53818-3110
(608) 348-9766
(608) 348-3915
Mailing address
275 W MAIN ST, PO BOX 704, PLATTEVILLE, WI 53818-3110
(608) 348-9766
(608) 348-3915

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
261QP2300X
Primary Care Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41863200
WI
05
42005400
WI
05
43973600
WI
05
44008100
WI
Enumeration date
04/05/2012
Last updated
04/05/2012
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