Individual
MARY E TAGGETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1185 CORPORATE CENTER DR, STE 175, OCONOMOWOC, WI 53066-4887
(262) 928-8400
Mailing address
1185 CORPORATE CENTER DR, STE 175, OCONOMOWOC, WI 53066-4887
(262) 928-8400
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2200
WI
363LA2100X
Acute Care Nurse Practitioner
105021
WI
Other
Enumeration date
08/17/2006
Last updated
06/03/2015
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