Individual
DARCIE RODEBACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1210 RIDGE RD, CUSTER, WI 54423-9430
(715) 240-0294
Mailing address
1210 RIDGE RD, CUSTER, WI 54423-9430
(715) 240-0294
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
265100-30
WI
163WP0200X
Pediatric Registered Nurse
Primary
265100-30
WI
Other
Enumeration date
07/11/2023
Last updated
07/11/2023
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