Individual
MRS. CEARA JENELLE DEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
98 POLK ST, NORTH FOND DU LAC, WI 54937-1253
(920) 659-1371
Mailing address
98 POLK ST, NORTH FOND DU LAC, WI 54937-1253
(920) 659-1371
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
322493
WI
Other
Enumeration date
08/20/2019
Last updated
08/20/2019
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