Individual
AMY LYNN NYSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
E5302 670TH AVE, MENOMONIE, WI 54751-1123
(651) 295-2483
Mailing address
E5302 670TH AVE, MENOMONIE, WI 54751-1123
(651) 295-2483
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
174679-0
WI
163W00000X
Registered Nurse
Primary
175282
WI
Other
Enumeration date
11/16/2020
Last updated
11/16/2020
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