Individual
HEIDI ELIZABETH BESCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
525 WALLACE ST, NEW LONDON, WI 54961-2165
(715) 281-0782
Mailing address
359 OAK ST, MENASHA, WI 54952-3335
(920) 851-0838
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
324091
WI
Other
Enumeration date
07/26/2019
Last updated
07/26/2019
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