Grace Kathryn Kikkebusch, DO
Student in an Organized Health Care Education/Training Program in Milwaukee, WI. Individual provider (NPI-1).
NPI number1124715420
StatusActive
Last updated in NPPESApr 18, 2023
Details
- NPI
- 1124715420
- Entity type
- Individual (NPI-1)
- Name
- Grace Kathryn Kikkebusch
- Credential
- DO
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 18, 2023
- Certification date
- Apr 18, 2023
- Last updated
- Apr 18, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
900 N 92nd StMilwaukee, WI 53226-1202
Phone 414-955-4985
Mailing address
900 N 92nd StMilwaukee, WI 53226-1202
Phone 414-955-4985
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