Individual
KENNETTA BANYARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6958 N RAINTREE DR UNIT D, MILWAUKEE, WI 53223-5271
(414) 795-9008
Mailing address
6958 N RAINTREE DR UNIT D, MILWAUKEE, WI 53223-5271
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
314712
WI
Other
Enumeration date
10/28/2014
Last updated
10/28/2014
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