Individual
MRS. KIM MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2422 N GRANDVIEW BLVD, WAUKESHA, WI 53188-6105
(262) 549-6600
Mailing address
2422 N GRANDVIEW BLVD, WAUKESHA, WI 53188-6105
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
316749-31
WI
Other
Enumeration date
01/23/2015
Last updated
01/23/2015
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