Provider Demographics
NPI:1134961766
Name:CHMIEL, JOAN LEIGH (P&ICD)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:LEIGH
Last Name:CHMIEL
Suffix:
Gender:F
Credentials:P&ICD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 S WENTWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-2511
Mailing Address - Country:US
Mailing Address - Phone:414-416-7519
Mailing Address - Fax:
Practice Address - Street 1:2901 S WENTWORTH AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207-2511
Practice Address - Country:US
Practice Address - Phone:414-416-7519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-12
Last Update Date:2024-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty