Healthcare Provider Details

I. General information

NPI: 1114274107
Provider Name (Legal Business Name): HOLLY A ONSAGER MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2012
Last Update Date: 08/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2014 E WEBSTER PL
MILWAUKEE WI
53211-4047
US

IV. Provider business mailing address

2014 E WEBSTER PL
MILWAUKEE WI
53211-4047
US

V. Phone/Fax

Practice location:
  • Phone: 414-962-5766
  • Fax:
Mailing address:
  • Phone: 414-962-5766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number658995-30
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License Number65895-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: