Provider Demographics
NPI:1174826804
Name:MARKIELEWSKI, MARY S (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:S
Last Name:MARKIELEWSKI
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5961 COUNTY ROAD K
Mailing Address - Street 2:
Mailing Address - City:WAUNAKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53597-9414
Mailing Address - Country:US
Mailing Address - Phone:608-850-3245
Mailing Address - Fax:
Practice Address - Street 1:5961 COUNTY ROAD K
Practice Address - Street 2:
Practice Address - City:WAUNAKEE
Practice Address - State:WI
Practice Address - Zip Code:53597-9414
Practice Address - Country:US
Practice Address - Phone:608-850-3245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-20
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI59989-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse