Provider Demographics
NPI:1275766420
Name:CONGEMI, MICHAEL SCOTT (ACNP-BC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:SCOTT
Last Name:CONGEMI
Suffix:
Gender:M
Credentials:ACNP-BC
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:W236S7050 BIG BEND DR STE 6
Mailing Address - Street 2:
Mailing Address - City:BIG BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53103-9497
Mailing Address - Country:US
Mailing Address - Phone:262-436-1340
Mailing Address - Fax:262-436-9571
Practice Address - Street 1:W236S7050 BIG BEND DR STE 6
Practice Address - Street 2:
Practice Address - City:BIG BEND
Practice Address - State:WI
Practice Address - Zip Code:53103-9497
Practice Address - Country:US
Practice Address - Phone:262-436-1340
Practice Address - Fax:262-436-9571
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI3809-033363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care