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1992944300
BARBARA J. PROVO
MILWAUKEE, WI
NPI
1992944300
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Former Name
BARBARA J. GOEDDERZ
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: WI 3604)
Enumeration Date
2009-02-09
Last Update Date
2012-08-03
Business Address
Ms. BARBARA J. PROVO APNP
9200 W WISCONSIN AVE VASCULAR SURGERY
MILWAUKEE, WI 53226-3522
Phone number: 414-805-3902
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Mailing Address
Ms. BARBARA J. PROVO APNP
9200 W WISCONSIN AVE VASCULAR SURGERY
MILWAUKEE, WI 53226-3522
Phone number: 414-805-3902
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