Provider Demographics
NPI:1922735570
Name:GHAZAL, SAADIA (APRN)
Entity Type:Individual
Prefix:
First Name:SAADIA
Middle Name:
Last Name:GHAZAL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 210560
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53221-8010
Mailing Address - Country:US
Mailing Address - Phone:414-875-0505
Mailing Address - Fax:866-225-2790
Practice Address - Street 1:5434 W CAPITOL DR STE 3
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-2298
Practice Address - Country:US
Practice Address - Phone:414-875-0505
Practice Address - Fax:866-225-2790
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13045-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily