MEDICARE: MS. FELISA MARIE ANTONCHORGY APNP

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	363LA2100X	Acute Care Nurse Practitioner	3857-33	WI

General Provider Information

NPI Number	:	1750617536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. FELISA MARIE ANTONCHORGY APNP

Provider Business Mailing Address
First Line	:	2741 W LAYTON AVE
Second Line	:	SUITE 201
City	:	MILWAUKEE
State	:	WI
Zip	:	53221-2600
Country	:	US
Telephone Number	:	414-672-8050
Fax Number	:	414-672-1050

Provider Business Practice Location Address
First Line	:	2741 W LAYTON AVE
Second Line	:	SUITE 201
City	:	MILWAUKEE
State	:	WI
Zip	:	53221-2600
Country	:	US
Telephone Number	:	414-672-8050
Fax Number	:	414-672-1050

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

Provider Enumeration Date	:	10/28/2009
Last Update Date	:	05/25/2022

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