Healthcare Provider Details

I. General information

NPI: 1376718650
Provider Name (Legal Business Name): DENISE POWELL ABERNETHY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2008
Last Update Date: 01/24/2023
Certification Date: 04/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7003 S HOWELL AVE STE 1600
OAK CREEK WI
53154-1460
US

IV. Provider business mailing address

7003 S HOWELL AVE STE 1600
OAK CREEK WI
53154-1460
US

V. Phone/Fax

Practice location:
  • Phone: 262-476-4900
  • Fax: 414-395-8925
Mailing address:
  • Phone: 262-476-9000
  • Fax: 414-395-8925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number53598
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number53598
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: