Individual
AMANDA DEREMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
82 FALLING CREEK CIR, JANESVILLE, WI 53548-9106
(608) 449-1399
Mailing address
82 FALLING CREEK CIR, JANESVILLE, WI 53548-9106
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
318603
WI
Other
Enumeration date
10/22/2014
Last updated
10/22/2014
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