Individual
MISS STACY DANIELLE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4468 NORTH 21ST STREET, MILWAUKEE, WI 53209-9998
(414) 412-6063
Mailing address
4468 NORTH 21ST STREET, MILWAUKEE, WI 53209-9998
(414) 412-6063
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
311555-31
WI
Other
Enumeration date
09/13/2012
Last updated
09/13/2012
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