Individual
STACY BOUPLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
903 S 30TH ST, MANITOWOC, WI 54220-4317
(920) 287-9285
Mailing address
903 S 30TH ST, MANITOWOC, WI 54220-4317
(920) 287-9285
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
33080-31
WI
Other
Enumeration date
05/21/2024
Last updated
05/21/2024
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