Individual
MRS. NICOLE MARIE REISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1102 S 47TH ST, WEST MILWAUKEE, WI 53214-3504
(414) 801-7146
Mailing address
1102 S 47TH ST, WEST MILWAUKEE, WI 53214-3504
(414) 801-7146
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
305222-31
WI
Other
Enumeration date
09/28/2011
Last updated
04/26/2013
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