Provider Demographics
NPI:1215993555
Name:PAUL, ANGELA M (NP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:PAUL
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:SCHMITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8701 WATERTOWN PLANK RD
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3548
Mailing Address - Country:US
Mailing Address - Phone:414-955-1730
Mailing Address - Fax:414-955-0072
Practice Address - Street 1:MEDICAL COLLEGE OF WISCONSIN
Practice Address - Street 2:8701 WATERTOWN PLANK RD.
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226
Practice Address - Country:US
Practice Address - Phone:414-955-1700
Practice Address - Fax:414-955-0072
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2578033363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41256100Medicaid
Q28003Medicare UPIN
WI002102870Medicare ID - Type Unspecified