Healthcare Provider Details

I. General information

NPI: 1093633794
Provider Name (Legal Business Name): ANA BERNAL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1028 S 9TH ST
MILWAUKEE WI
53204-1395
US

IV. Provider business mailing address

1028 S 9TH ST
MILWAUKEE WI
53204-1395
US

V. Phone/Fax

Practice location:
  • Phone: 414-649-2805
  • Fax: 414-649-2824
Mailing address:
  • Phone: 414-649-2805
  • Fax: 414-649-2824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number174718-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: