Individual
BRIDGET KENNY ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(414) 337-7300
(414) 337-7337
Mailing address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(414) 337-7300
(414) 337-7337
Taxonomy
Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
82336
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063944312
—
WI
Enumeration date
03/28/2017
Last updated
03/11/2024
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