Healthcare Provider Details

I. General information

NPI: 1407691900
Provider Name (Legal Business Name): VERONICA ANN CROSS PHLEBOTOMY CPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2024
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 N 37TH ST
MILWAUKEE WI
53210-1801
US

IV. Provider business mailing address

2950 N 37TH ST
MILWAUKEE WI
53210-1801
US

V. Phone/Fax

Practice location:
  • Phone: 414-699-3269
  • Fax:
Mailing address:
  • Phone: 414-699-3269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number10147107
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: