Healthcare Provider Details

I. General information

NPI: 1891065967
Provider Name (Legal Business Name): ANN M DRAGHICCHIO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANN M WILFORD

II. Dates (important events)

Enumeration Date: 01/06/2012
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W180N8085 TOWN HALL RD
MENOMONEE FALLS WI
53051-3518
US

IV. Provider business mailing address

959 N MAYFAIR ROAD
MILWAUKEE WI
53226
US

V. Phone/Fax

Practice location:
  • Phone: 262-257-2784
  • Fax: 262-250-7440
Mailing address:
  • Phone: 414-955-7601
  • Fax: 414-955-6020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number121465
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: