Individual
MRS. MARY THERESE LEVEILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1100 ORCHARD ST, SEYMOUR, WI 54165
(920) 833-5100
(920) 833-5130
Mailing address
1100 ORCHARD ST, SEYMOUR, WI 54165
(920) 833-5100
(920) 833-5130
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
69002
WI
363L00000X
Nurse Practitioner
Primary
1456
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43909800
—
WI
Enumeration date
07/26/2006
Last updated
11/10/2011
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