Individual
VICKIE R GAILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4480 N 85TH ST, MILWAUKEE, WI 53225-5108
(414) 461-8084
Mailing address
4480 N 85TH ST, MILWAUKEE, WI 53225-5108
(414) 461-8084
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
34494-31
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38334900
—
WI
Enumeration date
08/26/2008
Last updated
08/26/2008
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