Provider Demographics
NPI:1891975306
Name:RABBITT, ANGELA LEA (DO)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:LEA
Last Name:RABBITT
Suffix:
Gender:F
Credentials:DO
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:DIVISION OF CHILD PROTECTION
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-266-2090
Mailing Address - Fax:414-266-3157
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:DIVISION OF CHILD PROTECTION
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:414-266-2090
Practice Address - Fax:414-266-3157
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2007001635208000000X
WI530482080C0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080C0008XAllopathic & Osteopathic PhysiciansPediatricsChild Abuse Pediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1891975306Medicaid
WI736011506Medicare PIN