Healthcare Provider Details

I. General information

NPI: 1023654662
Provider Name (Legal Business Name): ANNA E SECKAR-ANDERSON APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA E SIMONICH

II. Dates (important events)

Enumeration Date: 11/19/2019
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6901 W EDGERTON AVE
GREENFIELD WI
53220-4420
US

IV. Provider business mailing address

PO BOX 735044
CHICAGO IL
60673-5044
US

V. Phone/Fax

Practice location:
  • Phone: 414-325-5244
  • Fax: 414-421-3772
Mailing address:
  • Phone: 800-326-2250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9757-33
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number10769
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number9757
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number220513
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: