Individual
KEITH ANTHONY STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5000 W NATIONAL AVE, MILWAUKEE, WI 53295-0001
(414) 384-2000
Mailing address
4129 N PROSPECT AVE, SHOREWOOD, WI 53211-1741
(414) 839-2591
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
140086-30
WI
Other
Enumeration date
02/06/2020
Last updated
02/06/2020
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