Provider Demographics
NPI:1457640948
Name:PELZEK, ANGELA MARIE (APNP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:PELZEK
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:MARIE
Other - Last Name:FELLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APNP
Mailing Address - Street 1:1555 N RIVER CENTER DR STE 206
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-3958
Mailing Address - Country:US
Mailing Address - Phone:414-272-5607
Mailing Address - Fax:414-272-5617
Practice Address - Street 1:1555 N RIVER CENTER DR STE 206
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212-3958
Practice Address - Country:US
Practice Address - Phone:414-272-5607
Practice Address - Fax:414-272-5617
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4326-033363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health