Individual
KEMBA BANYARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2468 W LISBON AVE, MILWAUKEE, WI 53205-1413
(414) 204-8488
Mailing address
2468 W LISBON AVE, MILWAUKEE, WI 53205-1413
(262) 977-7771
(262) 435-4929
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4887
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4887
WI
Other
Enumeration date
07/24/2012
Last updated
09/05/2019
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