Individual
MRS. REBECCA KAMPERSCHROER NICKELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3237 S 16TH STREET, MILWAUKEE, WI 53215-4526
(414) 647-5165
(414) 858-2230
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(414) 858-2200
(414) 858-2230
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1602-023
WI
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA18195
—
CA
Enumeration date
04/06/2006
Last updated
09/17/2024
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