Individual
BRIDGETTE N VIRGIL-TRAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5043 N 19TH ST, MILWAUKEE, WI 53209-3802
(414) 793-7802
Mailing address
5043 N 19TH ST, MILWAUKEE, WI 53209-5762
(414) 793-7802
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
306935-031
WI
Other
Enumeration date
07/16/2010
Last updated
09/20/2010
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