Individual
LISA WICKLINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2393 W ALLYN RD, MERCER, WI 54547-9402
(715) 892-6551
Mailing address
2393 W ALLYN RD, MERCER, WI 54547-9402
(715) 892-6551
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
98101
WI
Other
Enumeration date
09/09/2015
Last updated
09/09/2015
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