Provider Demographics
NPI: | 1700817889 |
---|---|
Name: | BERNER, MARGARET ANN (CNM, APNP) |
Entity Type: | Individual |
Prefix: | MS |
First Name: | MARGARET |
Middle Name: | ANN |
Last Name: | BERNER |
Suffix: | |
Gender: | F |
Credentials: | CNM, APNP |
Other - Prefix: | MRS |
Other - First Name: | MARGARET |
Other - Middle Name: | ANN |
Other - Last Name: | SZYDLIK |
Other - Suffix: | |
Other - Last Name Type: | Former Name |
Other - Credentials: | RN |
Mailing Address - Street 1: | 1834 W WISCONSIN AVE |
Mailing Address - Street 2: | SUITE 100 |
Mailing Address - City: | MILWAUKEE |
Mailing Address - State: | WI |
Mailing Address - Zip Code: | 53233-2125 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 414-933-9100 |
Mailing Address - Fax: | 414-933-9200 |
Practice Address - Street 1: | 1834 W WISCONSIN AVE |
Practice Address - Street 2: | SUITE 100 |
Practice Address - City: | MILWAUKEE |
Practice Address - State: | WI |
Practice Address - Zip Code: | 53233-2125 |
Practice Address - Country: | US |
Practice Address - Phone: | 414-933-9100 |
Practice Address - Fax: | 414-933-9200 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-07-06 |
Last Update Date: | 2011-12-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
WI | 139993-032 | 367A00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 367A00000X | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
WI | 43986600 | Medicaid | |
WI | 43986600 | Medicaid | |
WI | 000502028 | Medicare PIN |