Individual
CRYSTAL HILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
N9530 HORSESHOE LN, MUKWONAGO, WI 53149-1849
(706) 988-3008
Mailing address
N9530 HORSESHOE LN, MUKWONAGO, WI 53149-1849
(706) 988-3008
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
316184-31
WI
Other
Enumeration date
01/24/2014
Last updated
01/24/2014
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