Mary Supple, LPN

NPI #1447653662 in Watertown, Wisconsin

Provider Information

NPI Number
1447653662
Entity Type
Individual
Name
Mary Supple, LPN
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Licensed Practical Nurse
Credential
LPN
Enumeration Date
Oct 1, 2014
Last Updated
Oct 1, 2014

Practice Location

Address
N6288 STONEWOOD DR
ZIP Code
53094-8710
Phone
(920) 699-5780

Specialties & Taxonomy Codes

Specialty
Licensed Practical Nurse

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