Provider Demographics
NPI:1427009174
Name:THEW, MARGARET E (APNP)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:E
Last Name:THEW
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 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:ADOLESCENT MEDICINE
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-266-2754
Mailing Address - Fax:414-337-7020
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:ADOLESCENT MEDICINE
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:414-266-2754
Practice Address - Fax:414-337-7020
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1398363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1427009174Medicaid
000030377VOtherHUMANA
WI736011915Medicare PIN
WI1427009174Medicaid