Individual
MRS. MARNEY SCULLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6314 95TH AVE, KENOSHA, WI 53142-8166
(847) 354-1353
Mailing address
4404 KENSINGTON CT, GURNEE, IL 60031-6213
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
22476930
WI
Other
Enumeration date
11/12/2018
Last updated
11/12/2018
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