Provider Demographics
NPI:1801620190
Name:HOPE-IATRY LLC
Entity type:Organization
Organization Name:HOPE-IATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWSTER
Authorized Official - Suffix:
Authorized Official - Credentials:APNP
Authorized Official - Phone:262-391-2495
Mailing Address - Street 1:383 WILLIAMSTOWNE STE 301
Mailing Address - Street 2:
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-2332
Mailing Address - Country:US
Mailing Address - Phone:262-391-2495
Mailing Address - Fax:
Practice Address - Street 1:383 WILLIAMSTOWNE STE 301
Practice Address - Street 2:
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-2332
Practice Address - Country:US
Practice Address - Phone:262-391-2495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty