Individual
KATHLEEN SUE CARLSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5224 W JERELYN PL, MILWAUKEE, WI 53219-2273
(414) 321-3191
Mailing address
5224 W JERELYN PL, MILWAUKEE, WI 53219-2273
(414) 321-3191
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
12282-031
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39899500
—
WI
Enumeration date
05/05/2006
Last updated
07/08/2007
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