Individual
KYLIE LENZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1155 N MAYFAIR RD FL 3, MILWAUKEE, WI 53226-3464
(414) 955-5990
(414) 955-6282
Mailing address
1155 N MAYFAIR RD FL 3, MILWAUKEE, WI 53226-3464
(414) 955-5990
(414) 955-6282
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5271
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447878731
—
WI
Enumeration date
07/13/2020
Last updated
02/21/2022
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