Individual
KRISTIN MARIE HUMPAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
975 PORT WASHINGTON RD, GRAFTON, WI 53024-9204
(262) 329-1000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2307-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100001348
—
WI
Enumeration date
07/07/2008
Last updated
11/15/2023
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