Healthcare Provider Details

I. General information

NPI: 1437089364
Provider Name (Legal Business Name): MORGAN MASTROSTEFANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W180N8085 TOWN HALL RD
MENOMONEE FALLS WI
53051-3518
US

IV. Provider business mailing address

3685 S WILLOW GLEN DR
NEW BERLIN WI
53151-5363
US

V. Phone/Fax

Practice location:
  • Phone: 262-251-1000
  • Fax:
Mailing address:
  • Phone: 414-254-9558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number17695-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: