Individual
KEVIN AGESTA CORPORAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
500 E VETERANS ST, TOMAH, WI 54660-3105
(608) 372-3971
Mailing address
500 E VETERANS ST, TOMAH, WI 54660-3105
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
078411
PR
163W00000X
Registered Nurse
Primary
9523858
FL
Other
Enumeration date
04/03/2026
Last updated
04/03/2026
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