Provider Demographics
NPI:1700139631
Name:ATKOCAITIS, MARIE LOUISE (LPN)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:LOUISE
Last Name:ATKOCAITIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3113 EAST WASHINGTON AVE
Mailing Address - Street 2:MADISON HEALTH SERVICES
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-4330
Mailing Address - Country:US
Mailing Address - Phone:608-242-0220
Mailing Address - Fax:608-242-1166
Practice Address - Street 1:3113 EAST WASHINGTON AVE
Practice Address - Street 2:MADISON HEALTH SERVICES
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-4330
Practice Address - Country:US
Practice Address - Phone:608-242-0220
Practice Address - Fax:608-242-1166
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI303842-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse