Individual
NATASHA MAIRE BUBOLZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
14386 WARRINGTON LAKE DR, GILLETT, WI 54124-9793
(920) 598-0712
Mailing address
14386 WARRINGTON LAKE DR, GILLETT, WI 54124-9793
(920) 598-0712
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
325780
WI
Other
Enumeration date
01/25/2023
Last updated
01/25/2023
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