Individual
GLORIA VASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
275 LAKEVIEW DR, WHITEWATER, WI 53190-2216
(262) 384-0400
Mailing address
275 LAKEVIEW DR, WHITEWATER, WI 53190-2216
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
312053-031
WI
Other
Enumeration date
03/28/2011
Last updated
03/28/2011
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