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Individual

KYLA PHU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
14555 W NATIONAL AVE, NEW BERLIN, WI 53151-4494
(844) 284-0381
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(844) 284-0381

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
100848
WI
363LF0000X
Family Nurse Practitioner
209013749
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100251414
WI
Enumeration date
03/22/2016
Last updated
10/17/2023
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