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Individual

KERRI L NICHOLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 948-7385
Mailing address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 948-7385

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209014179
IL
363LF0000X
Family Nurse Practitioner
Primary
7623-033
WI

Other

Enumeration date
06/06/2016
Last updated
11/22/2021
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