Individual
MARYSUE BODAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
1143 PARNELL ST, MARINETTE, WI 54143-3426
(715) 587-0935
Mailing address
1143 PARNELL ST, MARINETTE, WI 54143-3426
(715) 587-0935
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
166691
WI
Other
Enumeration date
02/02/2017
Last updated
02/02/2017
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