Individual
KAYLA MICHELLE PONCEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1630 CHIPPEWA DR, RHINELANDER, WI 54501-9503
(715) 361-5480
Mailing address
3564 DRISCOLL RD APT 12, RHINELANDER, WI 54501-3675
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9792
WI
Other
Enumeration date
12/11/2019
Last updated
12/11/2019
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