Provider Demographics
NPI:1043733710
Name:RIGHT AT YOUR DOOR
Entity Type:Organization
Organization Name:RIGHT AT YOUR DOOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUDSON-KINZEY
Authorized Official - Suffix:
Authorized Official - Credentials:MSN ED, RN
Authorized Official - Phone:414-522-0417
Mailing Address - Street 1:12605 W NORTH AVE # 282
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-4629
Mailing Address - Country:US
Mailing Address - Phone:414-522-0455
Mailing Address - Fax:414-509-6747
Practice Address - Street 1:9235 W CAPITOL DR STE LL1
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-1567
Practice Address - Country:US
Practice Address - Phone:414-522-0455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-24
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI124990163WH0200X
IL041338963163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL020368826365001Medicaid
WI100067593Medicaid