Individual
KAYLA MAE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
129 E PARK AVE APT 6, WAUKESHA, WI 53186-4973
(920) 851-1527
Mailing address
129 E PARK AVE APT 6, WAUKESHA, WI 53186-4973
(920) 851-1527
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
249729-30
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
249729-30
—
WI
05
—
KAYMAE2011
—
WI
Enumeration date
09/03/2019
Last updated
09/03/2019
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