Healthcare Provider Details

I. General information

NPI: 1215981568
Provider Name (Legal Business Name): ANN M CARLIN APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 08/07/2020
Certification Date: 08/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W WISCONSIN AVE DIVISION OF NEOPLASTIC DISEASES
MILWAUKEE WI
53226-3522
US

IV. Provider business mailing address

9200 W WISCONSIN AVE DIVISION OF NEOPLASTIC DISEASES
MILWAUKEE WI
53226-3522
US

V. Phone/Fax

Practice location:
  • Phone: 414-805-6800
  • Fax: 414-805-6808
Mailing address:
  • Phone: 414-805-6800
  • Fax: 414-805-6808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number87982
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: