Individual
MOENEEK CANNADAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
804 CLINTON ST, WAUKESHA, WI 53186-4797
(262) 617-0195
Mailing address
804 CLINTON ST, WAUKESHA, WI 53186-4797
(262) 617-0195
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100034083
—
WI
Enumeration date
02/21/2018
Last updated
02/21/2018
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