Individual provider · Type 1 NPI
Avery Fossum
Student in an Organized Health Care Education/Training Program · Madison, WI
NPI number
1043905185
Active
Practice location
858 Jupiter Dr
Madison, WI 53718-2946
Mailing address
3053 Oak Leaf Cir
Fitchburg, WI 53711-5846
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | None listed |
Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
4 other providers at this address
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About NPI 1043905185
Avery Fossum's National Provider Identifier is 1043905185, issued on Apr 5, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Madison, WI. The record was last updated on Apr 5, 2023.