Individual
MRS. KAYLA ANN EBBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
N4673 MAYFLOWER RD, BLACK CREEK, WI 54106-8025
(920) 757-5716
Mailing address
1314 COOLIDGE AVE, LITTLE CHUTE, WI 54140-2340
(920) 536-0831
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
241330
WI
Other
Enumeration date
07/25/2019
Last updated
12/31/2019
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