| NPI | 1801958871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTA GLEBKE Owner 715-213-6379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 1151-033) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2020-08-22 |