Individual
MARY ITZENHEISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
252 MCHENRY ST, BURLINGTON, WI 53105-1828
(262) 767-6487
Mailing address
252 MCHENRY ST, BURLINGTON, WI 53105-1828
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
91388-30
WI
Other
Enumeration date
12/29/2016
Last updated
12/29/2016
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