Healthcare Provider Details

I. General information

NPI: 1881003861
Provider Name (Legal Business Name): MAISEE M SAYAOVANG DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2014
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3727 W WISCONSIN AVE
MILWAUKEE WI
53208-3182
US

IV. Provider business mailing address

2400 W VILLARD AVE
MILWAUKEE WI
53209-4901
US

V. Phone/Fax

Practice location:
  • Phone: 414-291-2626
  • Fax: 855-209-9615
Mailing address:
  • Phone: 414-527-8191
  • Fax: 414-527-8046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number166046
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number6029
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: