Provider Demographics
NPI:1134457591
Name:RING, MARY MATHEWSON (LPN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:MATHEWSON
Last Name:RING
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 HARRINGTON DR
Mailing Address - Street 2:#301
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53718-3273
Mailing Address - Country:US
Mailing Address - Phone:608-512-9779
Mailing Address - Fax:
Practice Address - Street 1:929 HARRINGTON DR
Practice Address - Street 2:#301
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53718-3273
Practice Address - Country:US
Practice Address - Phone:608-512-9779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17607-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse