| NPI | 1033447594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDI MARY MANN Owner 920-339-5252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner Women's Health (Licence: WI 115-030) |
| Enumeration Date | 2009-11-20 |
| Last Update Date | 2009-11-20 |