Healthcare Provider Details

I. General information

NPI: 1740842012
Provider Name (Legal Business Name): CLAIRE MASLOWSKI APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2019
Last Update Date: 07/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2428 N GRANDVIEW BLVD STE 102
WAUKESHA WI
53188-6906
US

IV. Provider business mailing address

150 S JAMES ST
WAUKESHA WI
53186-6221
US

V. Phone/Fax

Practice location:
  • Phone: 877-307-3226
  • Fax: 866-384-9486
Mailing address:
  • Phone: 414-339-3505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9321-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: