Healthcare Provider Details

I. General information

NPI: 1780544510
Provider Name (Legal Business Name): VICTORIA JEAN TURK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VICTORIA JEAN GALLE

II. Dates (important events)

Enumeration Date: 11/14/2025
Last Update Date: 11/14/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2970-2974 CHASE AVENUE
MILWAUKEE WI
53207
US

IV. Provider business mailing address

N16W26571 TALL REEDS LN UNIT F
PEWAUKEE WI
53072-6611
US

V. Phone/Fax

Practice location:
  • Phone: 414-934-6400
  • Fax:
Mailing address:
  • Phone: 414-934-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number161749-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: