MEDICARE: DANIEL KENNER

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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1982342978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL KENNER

Provider Business Mailing Address
First Line	:	4057 N 68TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-1112
Country	:	US
Telephone Number	:	262-416-2224
Fax Number	:

Provider Business Practice Location Address
First Line	:	4057 N 68TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-1112
Country	:	US
Telephone Number	:	262-416-2224
Fax Number	:

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

Provider Enumeration Date	:	05/20/2022
Last Update Date	:	05/20/2022

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Directions to “ DANIEL KENNER ” Practice Location

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