Individual
KELLY SIDHU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18740 W BLUEMOUND RD, BROOKFIELD, WI 53045-2936
(877) 307-3226
Mailing address
PO BOX 474, HARTLAND, WI 53029-0474
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
6312-33
WI
Other
Enumeration date
04/02/2015
Last updated
02/08/2017
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