Individual
PENNY RAE CLEWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1531 AIRPORT AVE, WISCONSIN RAPIDS, WI 54494-6376
(715) 213-3869
Mailing address
1531 AIRPORT AVE, WISCONSIN RAPIDS, WI 54494-6376
(715) 213-3869
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
57783-30
WI
Other
Enumeration date
02/18/2019
Last updated
02/18/2019
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