Individual
DANIELLE RAE IRISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1550 WILDWOOD DR, PLAIN, WI 53577-9644
(414) 510-7468
Mailing address
1434 BELLFLOWER LN, MADISON, WI 53719-4539
(414) 510-7468
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
306634-31
WI
Other
Enumeration date
04/23/2012
Last updated
04/23/2012
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