Individual
MARY JAMIE CAIRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6811 118TH AVE, KENOSHA, WI 53142-8420
(262) 857-5750
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
693
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43904300
—
WI
01
—
P00823712
RR MEDICARE
WI
Enumeration date
11/02/2005
Last updated
01/15/2024
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