Provider Demographics
NPI:1396584785
Name:VENABLE, PRECIOUS (CPT, MA)
Entity type:Individual
Prefix:
First Name:PRECIOUS
Middle Name:
Last Name:VENABLE
Suffix:
Gender:F
Credentials:CPT, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 N 24TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53206-1103
Mailing Address - Country:US
Mailing Address - Phone:414-249-1304
Mailing Address - Fax:
Practice Address - Street 1:3050 N 24TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53206-1103
Practice Address - Country:US
Practice Address - Phone:414-249-1304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIW7J3A7F2246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy