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Individual

KIMBERLY A MCCLAIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
311760-31

Contact information

Practice address
1504 OWEN AVE, RACINE, WI 53403-2145
(262) 412-4301
Mailing address
1504 OWEN AVE, RACINE, WI 53403-2145
(262) 412-4301

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
311760-31
WI

Other

Enumeration date
11/29/2010
Last updated
11/29/2010
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