Individual
KELLY RAFFERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4690 WINDING CREEK TRL, ABRAMS, WI 54101-9576
(920) 819-6197
Mailing address
4690 WINDING CREEK TRL, ABRAMS, WI 54101-9576
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
302119-031
WI
Other
Enumeration date
12/05/2013
Last updated
12/05/2013
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