Individual
KIMBERLY RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4061 N. 54TH STREET, PIGGLY WIGGLY FOOD MARKET, MILWAUKEE, WI 53216
(414) 447-1750
(414) 447-1757
Mailing address
2555 NORTH DR. MARTIN LUTHER KING JR. DRIVE, MILWAUKEE, WI 53212
(414) 267-2821
(414) 372-7289
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1870-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1870-033
LICENSE
WI
Enumeration date
02/16/2007
Last updated
09/10/2012
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