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General NPI Number Information
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NPI Number | 1962144956
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Entity Type | Individual
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Provider Name | JUSTICE ROSE DUNNING LPN
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Gender | Female
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Dates
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Enumeration Date | 04/11/2022
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Last Update Date | 04/11/2022
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Provider Practice Location Address
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Address Line | N6269 1323RD ST
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City | PRESCOTT
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State | WI
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Zip | 54021-7003
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Country | US
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Telephone | 651-558-1893
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Fax |
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Provider Business Mailing Address
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Address Line | N6269 1323RD ST
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City | PRESCOTT
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State | WI
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Zip | 54021-7003
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Country | US
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Telephone | 651-248-1029
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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 | 784892
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License Number State | MN
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