Individual
MRS. CHRISTINE B KAMELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2801 W KK RIVER PARKWAY, SUITE 245, MILWAUKEE, WI 53215
(414) 649-6780
(414) 649-6030
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2252
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000719
—
WI
05
—
1821090440
—
WI
01
—
739750881
MEDICARE PROVIDER
WI
Enumeration date
08/12/2005
Last updated
10/23/2023
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