Individual
MS. DESTINI RAWLS-KEYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1635 N 22ND ST, MILWAUKEE, WI 53205-1536
(414) 678-8057
Mailing address
1635 N 22ND ST, MILWAUKEE, WI 53205-1536
(414) 678-8057
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
311547-031
WI
Other
Enumeration date
08/11/2010
Last updated
08/11/2010
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