Individual
LAKENDRA MYNETTA MATTOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3172 N 75TH ST APT 1, MILWAUKEE, WI 53216-2765
(414) 322-8257
Mailing address
3172 N 75TH ST APT 1, MILWAUKEE, WI 53216-2765
(414) 322-8257
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
—
WI
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
05/11/2022
Last updated
05/11/2022
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