Healthcare Provider Details

I. General information

NPI: 1942637921
Provider Name (Legal Business Name): ROBIN JULIANNE POEDEL PHD, RN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2013
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 W HISTORIC MITCHELL ST
MILWAUKEE WI
53204-3533
US

IV. Provider business mailing address

930 W HISTORIC MITCHELL ST
MILWAUKEE WI
53204-3533
US

V. Phone/Fax

Practice location:
  • Phone: 414-383-9526
  • Fax: 414-649-2711
Mailing address:
  • Phone: 414-383-9526
  • Fax: 414-649-2711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9577
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: