Eds

NPI #1740230416 in Stoughton, Wisconsin

Provider Information

NPI Number: 1740230416
Entity Type: Organization
Organization Name: Eds
Primary Specialty: Registered Nurse
Enumeration Date: May 11, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 1202 N PAGE ST
City: Stoughton
State: Wisconsin
ZIP Code: 53589-1161
Phone: (608) 205-9974

Authorized Official

Name: JAMIE L WALLACE
Title: REGISTERED NURSE
Phone: (608) 205-9974

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Registered Nurse	163W00000X	Primary

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