Individual
LINDA CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
402 WEST LAKE ST., FRIENDSHIP, WI 53934
(608) 339-8370
Mailing address
402 WEST LAKE ST., FRIENDSHIP, WI 53934
(608) 339-8370
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2207-33
WI
363LG0600X
Gerontology Nurse Practitioner
2207
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41187000
—
WI
Enumeration date
01/31/2007
Last updated
04/29/2015
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