Provider Demographics
NPI:1235252339
Name:VONFRANKENBERG, ANNETTE S (APNP)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:S
Last Name:VONFRANKENBERG
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7330 W LAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53220-3849
Mailing Address - Country:US
Mailing Address - Phone:414-877-4570
Mailing Address - Fax:262-228-6257
Practice Address - Street 1:7330 W LAYTON AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53220-3849
Practice Address - Country:US
Practice Address - Phone:414-877-4570
Practice Address - Fax:414-281-9884
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI552-33363L00000X
WI552363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1235252339Medicaid
WI1235252339Medicaid
WIK400361072Medicare PIN