NPI 1003583238

Eric Gerald Phelps

Practitioner Adult Care Home Facility Cornell, WI

Practice location

Address: 104 N 11th St, Cornell, WI 54732-8106
Phone: (715) 202-3586

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X

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Registry record

NPI: 1003583238
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Aug 2021
Record last updated: 25 Aug 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.