Provider Demographics
NPI:1740950260
Name:CHECK JANISCH, DEBRA (FNP-BC APNP)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:CHECK JANISCH
Suffix:
Gender:F
Credentials:FNP-BC APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 N 81ST ST
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53213-1601
Mailing Address - Country:US
Mailing Address - Phone:414-737-5626
Mailing Address - Fax:
Practice Address - Street 1:2007 N 81ST ST
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53213-1601
Practice Address - Country:US
Practice Address - Phone:414-737-5626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11320-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily