Individual
TIM M NORDWIG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
609 LABAREE ST, WATERTOWN, WI 53098-3019
(920) 262-9499
Mailing address
609 LABAREE ST, WATERTOWN, WI 53098-3019
(920) 262-9499
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
60954
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39818100
—
WI
Enumeration date
03/24/2006
Last updated
07/09/2007
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