Individual
MONIQUE L CHISM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1610 MILLER PARK WAY, MILWAUKEE, WI 53214-3604
(414) 672-3801
Mailing address
1610 MILLER PARK WAY, MILWAUKEE, WI 53214-3604
(414) 672-3801
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
321707-31
WI
Other
Enumeration date
06/27/2022
Last updated
06/27/2022
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