Individual
KELLY WEISSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
322 WASHBURN RD, DEERFIELD, WI 53531-9577
(608) 764-1492
Mailing address
322 WASHBURN RD, DEERFIELD, WI 53531-9577
(608) 764-1492
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
185704-30
WI
Other
Enumeration date
12/06/2013
Last updated
12/06/2013
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