Individual
LYNETTE FAMOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3707 N RICHARDS ST, MILWAUKEE, WI 53212-1673
(414) 967-7006
Mailing address
2105 FRANKIE PL, MT PLEASANT, WI 53406-6100
(262) 822-6751
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
306794
WI
Other
Enumeration date
04/09/2015
Last updated
04/09/2015
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