Healthcare Provider Details

I. General information

NPI: 1437945219
Provider Name (Legal Business Name): KEYUIA PAIGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2025
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7545 N 90TH ST
MILWAUKEE WI
53224-4007
US

IV. Provider business mailing address

7545 N 90TH ST
MILWAUKEE WI
53224-4007
US

V. Phone/Fax

Practice location:
  • Phone: 414-837-0966
  • Fax:
Mailing address:
  • Phone: 414-837-0966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: