Individual
KELLY KERSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
8721 W HAWTHORNE AVE, WAUWATOSA, WI 53226-4641
(262) 305-3658
Mailing address
8721 W HAWTHORNE AVE, WAUWATOSA, WI 53226-4641
(262) 305-3658
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
178044-30
WI
Other
Enumeration date
02/15/2014
Last updated
02/15/2014
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