Individual
KIMBERLY A WEISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
9200 W WISCONSIN AVE, DEPT OF INTERNAL MEDICINE, MILWAUKEE, WI 53226-3522
(414) 805-6850
(414) 805-6851
Mailing address
9200 W WISCONSIN AVE, DEPT OF INTERNAL MEDICINE, MILWAUKEE, WI 53226-3522
(414) 805-6850
(414) 805-6851
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
15-01755
KS
363AM0700X
Medical Physician Assistant
Primary
3739-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083010284
—
WI
Enumeration date
11/15/2014
Last updated
09/14/2016
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