Individual
KRISTIN KIEKHAEFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1160 KEPLER DR, GREEN BAY, WI 54311-8321
(920) 288-5400
Mailing address
1160 KEPLER DR, GREEN BAY, WI 54311-8321
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000017131
CERTIFICATION NUMBER
WI
Enumeration date
02/05/2018
Last updated
02/05/2018
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