Individual
DR. NICOLE MARIE SHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1700 MILTON AVE, JANESVILLE, WI 53545-0833
(608) 756-0614
(608) 756-0634
Mailing address
1700 MILTON AVE UNIT 1, JANESVILLE, WI 53545-0833
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19875-40
WI
Other
Enumeration date
03/25/2020
Last updated
03/25/2020
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