Individual
LATRICE WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3876 E MARTIN AVE, CUDAHY, WI 53110-1912
(414) 899-2356
Mailing address
3876 E MARTIN AVE, CUDAHY, WI 53110-1912
(414) 899-2356
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
246128
WI
376K00000X
Nurse's Aide
—
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/02/2024
Last updated
05/02/2024
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