Individual
MRS. MARY BETH KISPERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5000 W NATIONAL AVE, MILWAUKEE, WI 53295-0001
(414) 384-2000
(414) 384-2939
Mailing address
9207 N TENNYSON DR, MILWAUKEE, WI 53217-1465
(414) 352-9080
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
80012
WI
Other
Enumeration date
07/16/2006
Last updated
07/08/2007
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