Healthcare Provider Details

I. General information

NPI: 1811819337
Provider Name (Legal Business Name): NATALIE WOOD-JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5462 N 55TH ST
MILWAUKEE WI
53218-3210
US

IV. Provider business mailing address

5462 N 55TH ST
MILWAUKEE WI
53218-3210
US

V. Phone/Fax

Practice location:
  • Phone: 414-215-5372
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: