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General NPI Number Information
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NPI Number | 1154027274
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Entity Type | Individual
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Provider Name | MINDY ECKSTEIN
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Gender | Female
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Dates
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Enumeration Date | 01/31/2023
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 1628 N MAIN ST
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City | OSHKOSH
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State | WI
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Zip | 54901-2916
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Country | US
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Telephone | 920-203-9857
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Fax |
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Provider Business Mailing Address
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Address Line | 3235 COUNTY ROAD FF
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City | OMRO
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State | WI
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Zip | 54963-9471
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Country | US
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Telephone | 920-203-9857
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State |
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