Individual
MR. KENNETH GORDON KALINOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APNP
Contact information
Practice address
250 26TH ST STE 130, PRAIRIE DU SAC, WI 53578-2205
(414) 325-7246
(414) 325-3770
Mailing address
4131 W LOOMIS RD STE 300, GREENFIELD, WI 53221-2059
(414) 325-7246
(414) 325-3770
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
125666030
WI
363L00000X
Nurse Practitioner
Primary
7939
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39968700
—
WI
Enumeration date
04/28/2006
Last updated
11/20/2017
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