Healthcare Provider Details

I. General information

NPI: 1588456214
Provider Name (Legal Business Name): ARIANE NELSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11007 W VILLA AVE
MILWAUKEE WI
53224-2590
US

IV. Provider business mailing address

11007 W VILLA AVE
MILWAUKEE WI
53224-2590
US

V. Phone/Fax

Practice location:
  • Phone: 414-254-7734
  • Fax: 414-254-7734
Mailing address:
  • Phone: 414-254-7734
  • Fax: 414-254-7734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: