Individual
AQUILLA ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5029 N 37TH ST, MILWAUKEE, WI 53209-5331
(414) 865-3285
Mailing address
5029 N 37TH ST, MILWAUKEE, WI 53209-5331
(414) 865-3285
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
244233
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000
—
WI
Enumeration date
03/27/2020
Last updated
03/27/2020
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