Individual
VIDALLAH MULLEY NORDQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
3400 MINISTRY PKWY, WESTON, WI 54476-5220
(715) 393-1220
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
230193
WI
363L00000X
Nurse Practitioner
Primary
14480
WI
363L00000X
Nurse Practitioner
230193-30
WI
363LG0600X
Gerontology Nurse Practitioner
14480-33
WI
363LG0600X
Gerontology Nurse Practitioner
230193-30
WI
Other
Enumeration date
08/22/2023
Last updated
02/19/2024
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