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Individual

ANDREA GUNDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
9532 E 16 FRONTAGE RD, STE. 100, ONALASKA, WI 54650-6739
(608) 783-0506
Mailing address
9532 E 16 FRONTAGE RD, STE. 100, ONALASKA, WI 54650-6739
(608) 783-0506

Taxonomy

Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
105046-30
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1003150004
WI
Enumeration date
03/14/2016
Last updated
03/14/2016
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