Healthcare Provider Details

I. General information

NPI: 1437324142
Provider Name (Legal Business Name): HELEN L GUDLEWSKI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2008
Last Update Date: 04/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

E11373 N REEDSBURG RD
BARABOO WI
53913-9410
US

IV. Provider business mailing address

E11373 N REEDSBURG RD
BARABOO WI
53913-9410
US

V. Phone/Fax

Practice location:
  • Phone: 563-940-2986
  • Fax:
Mailing address:
  • Phone: 563-940-2986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number157571-030
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: