Healthcare Provider Details

I. General information

NPI: 1174859524
Provider Name (Legal Business Name): HENRIETTA C ABILI DNP, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2009
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W SILVER SPRING DR STE B
GLENDALE WI
53209-4218
US

IV. Provider business mailing address

W131N6610 CRESTWOOD DR
MENOMONEE FALLS WI
53051-8316
US

V. Phone/Fax

Practice location:
  • Phone: 414-628-5392
  • Fax:
Mailing address:
  • Phone: 414-628-5392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4045-33
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4045-33
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number4045-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: