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General NPI Number Information
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NPI Number | 1598913501
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Entity Type | Individual
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Provider Name | MARSHA ANN NYTES LPN
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Gender | Female
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 09/03/2008
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Provider Practice Location Address
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Address Line | E8222 WEYAWEGA RD
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City | NEW LONDON
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State | WI
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Zip | 54961
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Country | US
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Telephone | 920-982-9021
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Fax |
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Provider Business Mailing Address
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Address Line | N8261 CTY RD 0
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City | BEAR CREEK
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State | WI
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Zip | 54922
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Country | US
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Telephone | 715-752-4828
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 304482031
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License Number State | WI
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