Individual
MS. BIANCA DELORES CARLYLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4945 N 105TH ST, MILWAUKEE, WI 53225-3918
(414) 388-1936
Mailing address
4945 N 105TH ST, MILWAUKEE, WI 53225-3918
(414) 388-1936
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
15741030
WI
163WH0200X
Home Health Registered Nurse
15741030
WI
Other
Enumeration date
01/28/2012
Last updated
01/28/2012
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