Provider Demographics
NPI:1598153033
Name:PRATHER, ARTESTA (RN)
Entity Type:Individual
Prefix:MS
First Name:ARTESTA
Middle Name:
Last Name:PRATHER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8509 W GRANTOSA DR APT 2
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53225-4969
Mailing Address - Country:US
Mailing Address - Phone:414-520-4286
Mailing Address - Fax:
Practice Address - Street 1:8509 W GRANTOSA DR APT 2
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53225-4969
Practice Address - Country:US
Practice Address - Phone:414-520-4286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI199514-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse