Individual
KERRE A KINGSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
2424 S 90TH ST, WEST ALLIS, WI 53227-2455
(414) 328-8150
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8800
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100084390
—
WI
Enumeration date
06/21/2018
Last updated
01/02/2025
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