Individual
JOANN KIEMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
146 E GENEVA SQ, LAKE GENEVA, WI 53147-9695
(262) 249-5030
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
PENDING
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36055500
—
WI
Enumeration date
08/20/2007
Last updated
01/08/2024
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