Individual
KIRSTEN J ANTONNEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1300 S GREEN BAY RD STE 100, MOUNT PLEASANT, WI 53406-4469
(262) 619-4191
(262) 634-5185
Mailing address
1515 S GREENBAY RD, RACINE, WI 53406-4409
(262) 632-1867
(262) 632-2656
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1981-23
WI
363AM0700X
Medical Physician Assistant
1981
WI
Other
Enumeration date
11/20/2006
Last updated
09/10/2021
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