MEDICARE: SONIA MICHELLE REEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide	NA218454	WI

General Provider Information

NPI Number	:	1104255413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONIA MICHELLE REEL

Provider Business Mailing Address
First Line	:	P.O.BOX 05011
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53205
Country	:	US
Telephone Number	:	414-852-5224
Fax Number	:

Provider Business Practice Location Address
First Line	:	2153 N 36TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53208-1406
Country	:	US
Telephone Number	:	414-553-5247
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2013
Last Update Date	:	11/06/2013

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Directions to “ SONIA MICHELLE REEL ” Practice Location

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