Provider Demographics
NPI:1497275945
Name:PIRES, MAGGIE M
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:M
Last Name:PIRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8859 W WATERFORD SQ N
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53228-2239
Mailing Address - Country:US
Mailing Address - Phone:262-501-9984
Mailing Address - Fax:
Practice Address - Street 1:8859 W WATERFORD SQ N
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53228-5322
Practice Address - Country:US
Practice Address - Phone:262-501-9984
Practice Address - Fax:262-501-9984
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-26
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI319909164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse