Individual
GINA M NYGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2118 125TH AVE, SAINT CROIX FALLS, WI 54024-8311
(414) 704-3446
Mailing address
2118 125TH AVE, SAINT CROIX FALLS, WI 54024-8311
(414) 704-3446
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
23569-031
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38260400
—
WI
Enumeration date
03/21/2006
Last updated
10/31/2010
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