Individual
MRS. KIMBERLY JEAN SEWELL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
35306 OAK KNOLL RD, BURLINGTON, WI 53105-9664
(262) 534-4403
Mailing address
35306 OAK KNOLL RD, BURLINGTON, WI 53105-9664
(262) 534-4403
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
33515-031
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40001200
—
WI
Enumeration date
06/03/2006
Last updated
07/08/2007
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