Individual
JOYCE M DEDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
650 MCMILLEN ST, FORT ATKINSON, WI 53538-1275
(920) 563-8900
(920) 563-0318
Mailing address
650 MCMILLEN ST, FORT ATKINSON, WI 53538-1275
(920) 563-8900
(920) 563-0318
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
93496-030
WI
363LW0102X
Women's Health Nurse Practitioner
Primary
186-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43836600
—
WI
Enumeration date
07/17/2006
Last updated
03/07/2023
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