Individual
MS. DIANE E. ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5000 WEST NATIONAL AVENUE, MILWAUKEE, WI 53295-0001
(414) 384-2000
(414) 382-5269
Mailing address
1548 KAULETTE DRIVE, GRAFTON, WI 53024-9652
(262) 618-4467
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
48926-030
WI
Other
Enumeration date
07/19/2006
Last updated
07/08/2007
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