Provider Demographics
NPI:1275703233
Name:DEVINE TOUHEY, MARY ELLEN (RN MSN FNP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELLEN
Last Name:DEVINE TOUHEY
Suffix:
Gender:F
Credentials:RN MSN FNP
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Mailing Address - Street 1:524 AMERICAN AVE
Mailing Address - Street 2:PROHEALTH CARE WOMEN'S CENTER
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-5031
Mailing Address - Country:US
Mailing Address - Phone:262-928-2594
Mailing Address - Fax:
Practice Address - Street 1:N79W28630 APPALOOSA LN
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-9038
Practice Address - Country:US
Practice Address - Phone:414-531-1676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI1988-33363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
683750593Medicare PIN