Organization
WISCONSIN HEALTHCARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEMBA BANYARD APNP DNP (ADMINISTRATOR)
(414) 433-7670
Entity
Organization
Contact information
Practice address
2462 WEST LISBON AVENUE, MILWAUKEE, WI 53205
(414) 433-7670
Mailing address
2462 WEST LISBON AVE, MILWAUKEE, WI 53205
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/14/2016
Last updated
09/14/2016
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