Individual
SALLY PEPPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
W1769 COUNTY ROAD J, MUKWONAGO, WI 53149-1833
(262) 684-5265
Mailing address
S75W33050 ROLLING FIELDS DR, MUKWONAGO, WI 53149-9311
(262) 392-4002
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0156675-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35052900
—
WI
Enumeration date
09/03/2008
Last updated
09/03/2008
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