| NPI | 1861291536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA MAE HARTZELL MIDDENDORF Owner 608-668-9118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Enumeration Date | 2025-03-13 |
| Last Update Date | 2025-04-24 |