Individual
EVGENIYA KHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
791 SUMMIT AVE, OCONOMOWOC, WI 53066-3844
(262) 569-9400
Mailing address
1078 RIVERKNOLL CIR, OCONOMOWOC, WI 53066-3478
(414) 308-7040
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
14346-33
WI
363LA2100X
Acute Care Nurse Practitioner
Primary
14346
WI
363LG0600X
Gerontology Nurse Practitioner
14346
WI
Other
Enumeration date
08/03/2023
Last updated
09/08/2023
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