Healthcare Provider Details

I. General information

NPI: 1508742420
Provider Name (Legal Business Name): ABIGAIL POE APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ABIGAIL RUCHTI

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 08/14/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3237 S 16TH ST
MILWAUKEE WI
53215-4526
US

IV. Provider business mailing address

9969 S 27TH ST STE 1400
FRANKLIN WI
53132-9533
US

V. Phone/Fax

Practice location:
  • Phone: 414-647-5000
  • Fax:
Mailing address:
  • Phone: 414-325-2240
  • Fax: 414-462-5923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number17262-33
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number17262-33
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number17262-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: