Individual
KELLY MEYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
N10971 YAEGER RD, CLINTONVILLE, WI 54929-9036
(920) 585-6869
Mailing address
N10971 YAEGER RD, CLINTONVILLE, WI 54929-9036
(920) 585-6869
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
319031
WI
Other
Enumeration date
03/28/2016
Last updated
03/28/2016
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