Individual
LAWANA G.BRYANT AL-DHARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2151 S MOUND ST, BAYVIEW, WI 53207-1331
(414) 630-0503
Mailing address
PO BOX 14113, WEST ALLIS, WI 53214-0113
(414) 630-0503
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
77548-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39805000
—
WI
Enumeration date
06/10/2006
Last updated
08/14/2007
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