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Individual

TYLOR ROCKWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1400 75TH ST, KENOSHA, WI 53143-1544
(262) 909-6008
(262) 764-8048
Mailing address
5237 ROBERTS DR, GREENDALE, WI 53129-2819
(330) 256-1358

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
15171-33
WI

Other

Enumeration date
03/20/2024
Last updated
03/20/2024
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