Individual
GRACE PATRICIA FAULKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
11136 ELDER RD, TOMAH, WI 54660-8089
(608) 372-6908
Mailing address
11136 ELDER RD, TOMAH, WI 54660-8089
(608) 372-6908
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
102272
WI
Other
Enumeration date
05/05/2006
Last updated
07/18/2008
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