Healthcare Provider Details

I. General information

NPI: 1487394821
Provider Name (Legal Business Name): APRIL MARIANNE GULFAN ENRIQUEZ FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIANNE ENRIQUEZ FNP-BC

II. Dates (important events)

Enumeration Date: 04/01/2022
Last Update Date: 04/01/2022
Certification Date: 04/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3727 W WISCONSIN AVE
MILWAUKEE WI
53208-3182
US

IV. Provider business mailing address

5665 GOLDEN RAIN CT
NEW BERLIN WI
53151-8733
US

V. Phone/Fax

Practice location:
  • Phone: 414-291-2626
  • Fax:
Mailing address:
  • Phone: 914-441-8748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2022000206
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: