Individual
HOLLY ANN DICARLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
S62W24372 TOWNLINE RD, WAUKESHA, WI 53189-9616
(262) 549-3266
Mailing address
S62 W24372 TOWNLINE RD, WAUKESHA, WI 53189-9616
(262) 549-3266
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
11528-031
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35064800
—
WI
Enumeration date
09/03/2008
Last updated
09/03/2008
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