Individual
NICOLE PLATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2236 HIGH RIDGE TRL, FITCHBURG, WI 53713-3626
(608) 395-9764
Mailing address
2927 COHO ST, MADISON, WI 53713-3069
(608) 663-9134
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
318814
WI
Other
Enumeration date
08/04/2016
Last updated
08/04/2016
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