Individual
CHANEL AYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1465 SHERIDAN RD, APT 1, KENOSHA, WI 53140-4444
(262) 744-8097
Mailing address
1465 SHERIDAN RD, APT 1, KENOSHA, WI 53140-4444
(262) 744-8097
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
321506
WI
Other
Enumeration date
04/14/2017
Last updated
04/14/2017
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