Individual
LATRICE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2954 N 21ST ST, MILWAUKEE, WI 53206-1631
(414) 915-0873
Mailing address
2954 N 21ST ST, MILWAUKEE, WI 53206-1631
(414) 915-0873
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
311148031
WI
Other
Enumeration date
07/01/2013
Last updated
10/09/2015
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