Individual
DESTINY AVERHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
11390 W THEODORE TRECKER WAY, WEST ALLIS, WI 53214-1135
(414) 928-1401
(414) 928-1402
Mailing address
11390 W THEODORE TRECKER WAY, WEST ALLIS, WI 53214-1135
(414) 928-1401
(414) 928-1402
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
331733
WI
Other
Enumeration date
11/10/2025
Last updated
11/10/2025
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