Individual
MARY KRIENKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3336 NAGAWICKA AVE, DELAFIELD, WI 53018-1021
(262) 646-4633
Mailing address
3336 NAGAWICKA AVE, DELAFIELD, WI 53018-1021
(262) 646-4633
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
1763-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40025200
—
WI
Enumeration date
04/07/2008
Last updated
04/07/2008
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