Individual
ABRISHA LYNN BRANTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5814 10TH AVE, KENOSHA, WI 53140-4009
(262) 873-7812
Mailing address
5814 10TH AVE, KENOSHA, WI 53140-4009
(262) 873-7812
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
326504-31
WI
Other
Enumeration date
03/30/2022
Last updated
03/30/2022
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