Individual
DR. MARK OLIVER PEASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APNP
Contact information
Practice address
W4051 HWY NN, ELKHORN, WI 53121-4338
(262) 741-3200
(262) 741-3217
Mailing address
5705 W OPEN MDW, MC FARLAND, WI 53558-8804
(608) 838-2075
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
392-33
WI
363L00000X
Nurse Practitioner
68680-30
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
392-33
WI
Other
Enumeration date
03/10/2010
Last updated
12/27/2013
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