MEDICARE: KALMETTE LYN CAMBRAY APNP, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	6406-033	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730561200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KALMETTE LYN CAMBRAY APNP, FNP-C

Provider Business Mailing Address
First Line	:	9200 W WISCONSIN AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-3522
Country	:	US
Telephone Number	:	414-805-0505
Fax Number	:	414-955-0231

Provider Business Practice Location Address
First Line	:	9200 W WISCONSIN AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-3522
Country	:	US
Telephone Number	:	414-805-0505
Fax Number	:	414-955-0231

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2015
Last Update Date	:	01/06/2026

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