Provider Demographics
NPI:1942451844
Name:WELLENSTEIN, MARIA K (NP)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:K
Last Name:WELLENSTEIN
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Gender:F
Credentials:NP
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Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:VASCULAR SURGERY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-6000
Mailing Address - Fax:414-805-6280
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:VASCULAR SURGERY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-6000
Practice Address - Fax:414-805-6280
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2016-09-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI3484363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1942451844Medicaid
WI1942451844Medicaid