Healthcare Provider Details

I. General information

NPI: 1528921657
Provider Name (Legal Business Name): ANGELA COLELLA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 11243
MILWAUKEE WI
53211-0243
US

IV. Provider business mailing address

PO BOX 11243
MILWAUKEE WI
53211-0243
US

V. Phone/Fax

Practice location:
  • Phone: 414-238-3534
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number17588-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: