Healthcare Provider Details

I. General information

NPI: 1003149295
Provider Name (Legal Business Name): ANNE E B LAKATOS APN-BC, APNP, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNE E BLAHA

II. Dates (important events)

Enumeration Date: 09/07/2009
Last Update Date: 12/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W WISCONSIN AVE DEPT OF INTERNAL MEDICINE
MILWAUKEE WI
53226-3522
US

IV. Provider business mailing address

9200 W WISCONSIN AVE DEPT OF INTERNAL MEDICINE
MILWAUKEE WI
53226-3522
US

V. Phone/Fax

Practice location:
  • Phone: 414-805-6850
  • Fax: 414-805-6851
Mailing address:
  • Phone: 414-805-6850
  • Fax: 414-805-6851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number3833
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number3833-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: