Provider Demographics
NPI:1083245021
Name:MACDONALD-MILEWSKI, AIDANNE LEIGH (ND)
Entity Type:Individual
Prefix:
First Name:AIDANNE
Middle Name:LEIGH
Last Name:MACDONALD-MILEWSKI
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1732 N PROSPECT AVE APT 905
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-1914
Mailing Address - Country:US
Mailing Address - Phone:262-424-4600
Mailing Address - Fax:
Practice Address - Street 1:4433 N OAKLAND AVE STE B
Practice Address - Street 2:
Practice Address - City:SHOREWOOD
Practice Address - State:WI
Practice Address - Zip Code:53211-1600
Practice Address - Country:US
Practice Address - Phone:414-939-8748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1109175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath