Individual
DR. KRISTIN D BENCIK BOUDREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
7950 N PORT WASHINGTON RD, FOX POINT, WI 53217-3131
(414) 228-0099
(414) 540-0165
Mailing address
7950 N PORT WASHINGTON RD, MILWAUKEE, WI 53217-3131
(414) 228-0099
(414) 540-1065
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
43405
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32858800
—
WI
Enumeration date
06/28/2005
Last updated
09/16/2020
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