Individual
KENNETH L. HALLWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1050 DIVISION ST, MAUSTON, WI 53948-1931
(608) 847-6161
Mailing address
1050 DIVISION ST, MAUSTON, WI 53948-1931
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3626-33
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
3626-33
WI
367500000X
Certified Registered Nurse Anesthetist
R148073-9
MN
Other
Enumeration date
11/14/2005
Last updated
11/08/2019
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