Individual
KELLEY MUENCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-1450
(414) 955-0197
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-1450
(414) 955-0197
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3329-23
WI
363AS0400X
Surgical Physician Assistant
3329-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679989321
—
WI
Enumeration date
07/02/2014
Last updated
03/17/2018
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