Individual
KENYETTE B BLUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1526 W NORTH AVE, MILWAUKEE, WI 53205-1237
(414) 510-7068
Mailing address
4230 N OAKLAND AVE # 189, SHOREWOOD, WI 53211-2042
(414) 331-0382
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
01/31/2022
Last updated
01/31/2022
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