Individual
KELSEY HENRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3434 E WASHINGTON AVE, MADISON, WI 53704-4155
(608) 443-5480
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4366-23
WI
Other
Enumeration date
06/08/2018
Last updated
05/04/2021
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