Individual
CONNIE ENDRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
15632 BUCK LN, MISHICOT, WI 54228-9434
(920) 755-4978
Mailing address
15632 BUCK LN, MISHICOT, WI 54228-9434
(920) 755-4978
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
306287-31
WI
Other
Enumeration date
02/18/2014
Last updated
02/18/2014
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