Individual
HARLY PRENTICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5911 E PLEASANT AVE, SOUTH RANGE, WI 54874-8728
(404) 807-5472
Mailing address
5911 E PLEASANT AVE, SOUTH RANGE, WI 54874-8728
(404) 807-5472
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
2472942
MN
Other
Enumeration date
05/03/2019
Last updated
05/03/2019
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