Individual
MCKAYLA Q THARP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY STE 980, MILWAUKEE, WI 53215-3689
(414) 384-5111
(414) 384-5040
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(414) 384-5111
(414) 384-5040
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
13303
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100230395
—
WI
Enumeration date
01/30/2023
Last updated
04/19/2023
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