Organization
STATE PRIVATE DUTY NURSING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE PATRICIA FAULKNER RN (PRIVATE DUTY NURSING)
(608) 372-6908
Entity
Organization
Contact information
Practice address
11136 ELDER RD, TOMAH, WI 54660-8089
(608) 372-6908
Mailing address
11136 ELDER RD, TOMAH, WI 54660-8089
(608) 372-6908
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
—
Other
Enumeration date
04/06/2006
Last updated
08/22/2020
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