Individual
KYLIE S NORDNESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3807 SPRING ST, RACINE, WI 53405-1667
(262) 687-8173
26
Mailing address
3807 SPRING ST, RACINE, WI 53405-1667
(262) 687-8173
26
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4946
WI
Other
Enumeration date
12/09/2019
Last updated
12/09/2019
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