Provider Demographics
NPI:1467979732
Name:KABAALE, RONALD (RN)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:KABAALE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5443 N 13TH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-5100
Mailing Address - Country:US
Mailing Address - Phone:414-797-4803
Mailing Address - Fax:
Practice Address - Street 1:5443 N 13TH STREET APT 4
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53209-5100
Practice Address - Country:US
Practice Address - Phone:414-797-4803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI176839163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care