Healthcare Provider Details

I. General information

NPI: 1942117510
Provider Name (Legal Business Name): LETICIA AGUIRRE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2430 W ROGERS ST
MILWAUKEE WI
53204-3655
US

IV. Provider business mailing address

2430 W ROGERS ST
MILWAUKEE WI
53204-3655
US

V. Phone/Fax

Practice location:
  • Phone: 414-902-1130
  • Fax: 414-902-1115
Mailing address:
  • Phone: 414-902-1130
  • Fax: 414-902-1115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number129570
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: