Individual
BETHANY DUCKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1350 CHARLES ST, ROCKFORD, IL 61104
(779) 696-0600
Mailing address
4817 POPLAR CREEK DR, MADISON, WI 53718-2130
(920) 960-0223
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209.029730
IL
Other
Enumeration date
05/24/2024
Last updated
05/24/2024
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