Provider Demographics
NPI:1821475120
Name:NAMAZI, AMIN (APNP)
Entity Type:Individual
Prefix:MR
First Name:AMIN
Middle Name:
Last Name:NAMAZI
Suffix:
Gender:M
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W193S8810 WIND CREST CT
Mailing Address - Street 2:
Mailing Address - City:MUSKEGO
Mailing Address - State:WI
Mailing Address - Zip Code:53150-7872
Mailing Address - Country:US
Mailing Address - Phone:414-217-3718
Mailing Address - Fax:
Practice Address - Street 1:725 AMERICAN AVE.
Practice Address - Street 2:PROHEALTH CARE WAUKESHA MEMORIAL HOSPITAL
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-5099
Practice Address - Country:US
Practice Address - Phone:262-928-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-06
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5933-33363LA2100X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health