Individual
KUMBA BAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2961 YARMOUTH GREENWAY DR, FITCHBURG, WI 53711-5809
(608) 665-1472
Mailing address
1026 W MAIN ST, SUN PRAIRIE, WI 53590-2040
(608) 395-8129
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
323911-31
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1-8233968852
—
WI
Enumeration date
09/27/2021
Last updated
09/27/2021
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