Individual
TRICIA A PROMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1855 S KOELLER ST, OSHKOSH, WI 54902-6214
(920) 223-7075
Mailing address
1855 S KOELLER ST, OSHKOSH, WI 54902-6214
(920) 223-7075
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
134723
WI
Other
Enumeration date
05/14/2010
Last updated
05/14/2010
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