Individual
AGNES M KANIKULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
825 MAIN ST, PLAIN, WI 53577-9668
(608) 546-4211
(608) 546-2440
Mailing address
825 MAIN ST, PLAIN, WI 53577-9668
(608) 546-4211
(608) 546-2440
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2616-23
WI
Other
Enumeration date
01/26/2011
Last updated
03/24/2021
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