CONNIE LEE WORM

SHEBOYGAN, WI
NPI1104044395
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: WI  86329-030)
Enumeration Date2007-04-23
Last Update Date2007-07-08
Business Address
-- CONNIE LEE WORM
2108 KOHLER MEMORIAL DR
SHEBOYGAN, WI 53081-3100
Phone number: 920-458-9401
Mailing Address
-- CONNIE LEE WORM
3532 N 21ST ST
SHEBOYGAN, WI 53083-2807
Phone number: 920-458-6556