Individual
MRS. MARY ANTOINETTE BAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
17417 DEVILS RIVER DR, MARIBEL, WI 54227-9506
(920) 863-8826
Mailing address
17417 DEVILS RIVER DR, MARIBEL, WI 54227-9506
(920) 863-8826
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
19438
WI
Other
Enumeration date
06/20/2011
Last updated
06/20/2011
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