Individual
WANDA ROTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
N9167 CEDAR AVE, EAST TROY, WI 53120-2211
(262) 363-5959
Mailing address
N9167 CEDAR AVE, EAST TROY, WI 53120-2211
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
122214
WI
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-31815
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163WL0100X
—
WI
Enumeration date
04/03/2017
Last updated
04/03/2017
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