Individual
SALLY SHOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
717 SPRUCE ST, VERONA, WI 53593-1644
(608) 576-9701
Mailing address
717 SPRUCE ST, VERONA, WI 53593-1644
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
59130-030
WI
163WP0200X
Pediatric Registered Nurse
59130-030
WI
Other
Enumeration date
12/04/2006
Last updated
02/11/2009
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