Individual
PORSHAE KIMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADULT FAMILY HOME
Contact information
Practice address
4428 W LLOYD ST, MILWAUKEE, WI 53208-1207
(414) 395-3360
Mailing address
4428 W LLOYD ST, MILWAUKEE, WI 53208-1207
(414) 395-3360
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
30311
WI
Other
Enumeration date
10/18/2020
Last updated
10/18/2020
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