Individual
MRS. TRUDY A MANDEL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
616 CIRCLE DR, MEQUON, WI 53092
(414) 915-3066
Mailing address
1055 12TH AVE, GRAFTON, WI 53024
(262) 375-4471
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
50665030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39859400
—
WI
Enumeration date
05/23/2006
Last updated
07/08/2007
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