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MRS. TRACIE BURNSIDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
3272 N 82ND ST, MILWAUKEE, WI 53222-3839
(414) 442-6094
(414) 342-1979
Mailing address
3272 N 82ND ST, MILWAUKEE, WI 53222-3839
(414) 442-6094
(414) 342-1979

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
WI

Other

Enumeration date
04/05/2006
Last updated
07/20/2007
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