Healthcare Provider Details

I. General information

NPI: 1831549252
Provider Name (Legal Business Name): DONNA IRENE ZEWEN-ROSSMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2016
Last Update Date: 03/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 W BROWN DEER RD STE 200
BROWN DEER WI
53209-1220
US

IV. Provider business mailing address

420 7TH ST
RACINE WI
53403-1222
US

V. Phone/Fax

Practice location:
  • Phone: 414-540-2170
  • Fax:
Mailing address:
  • Phone: 262-634-2391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number129914-121
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: