Healthcare Provider Details
I. General information
NPI: 1477630705
Provider Name (Legal Business Name): ANNE M. LENT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/01/2006
Last Update Date: 11/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2350 N LAKE DR SUITE 306
MILWAUKEE WI
53211-4528
US
IV. Provider business mailing address
788 N JEFFERSON ST SUITE 300/ ATTN. KAAREN BUTZEN
MILWAUKEE WI
53202-3718
US
V. Phone/Fax
- Phone: 414-298-7105
- Fax: 414-298-7195
- Phone: 414-272-8950
- Fax: 414-272-0859
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | 52144 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: