Individual
KIM MARIE WALTERS-CROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE
Contact information
Practice address
2215 PROGRESS BLVD, ANTIGO, WI 54409-2480
(715) 623-3797
(715) 627-2738
Mailing address
W6092 WOODS FLOWAGE RD, BRYANT, WI 54418-9591
(715) 623-3506
(715) 627-2738
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
307904-031
WI
Other
Enumeration date
01/18/2010
Last updated
01/18/2010
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