Provider Demographics
NPI:1467828798
Name:VISITING PRACTITIONERS OF WISCONSIN
Entity Type:Organization
Organization Name:VISITING PRACTITIONERS OF WISCONSIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARYEETEY
Authorized Official - Suffix:
Authorized Official - Credentials:APNP
Authorized Official - Phone:414-732-6132
Mailing Address - Street 1:5678 W BROWN DEER RD
Mailing Address - Street 2:STE 101
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223-2356
Mailing Address - Country:US
Mailing Address - Phone:414-732-6132
Mailing Address - Fax:
Practice Address - Street 1:5678 W BROWN DEER RD
Practice Address - Street 2:STE 101
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-2356
Practice Address - Country:US
Practice Address - Phone:414-732-6132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5455-33261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center