Individual
KIMBERLY J MORIARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9200 W WISCONSIN AVE, SURGICAL ONCOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-5020
(414) 805-5771
Mailing address
9200 W WISCONSIN AVE, SURGICAL ONCOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-5020
(414) 805-5771
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
146514
WI
363LF0000X
Family Nurse Practitioner
Primary
4146
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356662613
—
WI
Enumeration date
06/21/2010
Last updated
12/03/2019
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