Individual
ILONA AGATA PRYOMSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9201 WASHINGTON AVE, RACINE, WI 53406
(262) 321-3111
Mailing address
9201 WASHINGTON AVE, RACINE, WI 53406-3750
(262) 321-3111
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
7928-33
WI
363LG0600X
Gerontology Nurse Practitioner
7928-33
WI
Other
Enumeration date
08/27/2017
Last updated
06/11/2018
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