Lorelle Patricia Kiecker, PA
Physician Assistant in Milwaukee, WI. Individual provider (NPI-1).
NPI number1023764321
StatusActive
Last updated in NPPESMar 11, 2023
Details
- NPI
- 1023764321
- Entity type
- Individual (NPI-1)
- Name
- Ms. Lorelle Patricia Kiecker
- Credential
- PA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 24, 2022
- Certification date
- Mar 11, 2023
- Last updated
- Mar 11, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 7042-23 | WI | Yes |
Practice location
507 N 17th StMilwaukee, WI 53233
Phone 715-781-9731
Mailing address
507 N 17th StMilwaukee, WI 53233
Phone 715-781-9731
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