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Individual

KRISTIN LYN WASLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
W3985 COUNTY ROAD NN, ELKHORN, WI 53121-4337
(262) 741-2000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(262) 741-2000

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
7723
WI
363LF0000X
Family Nurse Practitioner
209009711
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100187312
WI
Enumeration date
08/08/2012
Last updated
10/23/2023
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