Individual
KELLY M WEBSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
W227N6103 SUSSEX RD, SUSSEX, WI 53089-3969
(414) 566-8100
Mailing address
1079 DICKENS DR, OCONOMOWOC, WI 53066-4314
(262) 443-9991
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
888691
WI
Other
Enumeration date
03/19/2020
Last updated
03/19/2020
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