Individual
LYNN WERNICKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
W3001 SAINT KILIAN DR, CAMPBELLSPORT, WI 53010-2561
(920) 533-5226
Mailing address
PO BOX 223, CAMPBELLSPORT, WI 53010-0223
(920) 533-5226
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
22783-031
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39878200
—
WI
Enumeration date
03/19/2007
Last updated
07/09/2007
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