Individual
RAZAN R ASSAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 948-5600
Mailing address
3841 W MINNESOTA AVE, FRANKLIN, WI 53132-9494
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
249689-30
WI
363L00000X
Nurse Practitioner
Primary
13347-33
WI
Other
Enumeration date
08/31/2022
Last updated
08/16/2023
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