Individual
MISS KRYSTAL LYNN WEIERSTAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-3666
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-3666
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
5101019918
MI
207L00000X
Anesthesiology Physician
Primary
65457
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316213804
—
WI
Enumeration date
03/28/2012
Last updated
07/21/2022
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