Individual
LOUISE M OMDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
4328 OLD GREEN BAY RD, MOUNT PLEASANT, WI 53403-9489
(262) 687-7606
Mailing address
4328 OLD GREEN BAY RD, MOUNT PLEASANT, WI 53403-9489
(262) 687-7606
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5208
WI
Other
Enumeration date
01/24/2013
Last updated
10/01/2013
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