Individual
KEVIN FORWARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11333 W NATIONAL AVE, MILWAUKEE, WI 53227-3111
(414) 328-4580
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5539-33
WI
363LA2200X
Adult Health Nurse Practitioner
5539-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100034870
—
WI
Enumeration date
11/02/2013
Last updated
03/12/2025
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