Individual
KENDRA KING I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5109 WORLD DAIRY DR, MADISON, WI 53718-3807
(608) 242-0220
(608) 242-1166
Mailing address
324 CLARK ST, RANDOLPH, WI 53956-1201
(608) 239-0933
(608) 242-1166
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
312037-31
WI
Other
Enumeration date
11/03/2015
Last updated
11/03/2015
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