Individual
KIMBERLY KETTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
W5451 ABEL DR, FOND DU LAC, WI 54937-7795
(920) 251-3494
Mailing address
W5451 ABEL DR, FOND DU LAC, WI 54937-7795
(920) 251-3494
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
157065-30
WI
Other
Enumeration date
02/23/2009
Last updated
02/23/2009
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