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General NPI Number Information
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NPI Number | 1023819109
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Entity Type | Individual
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Provider Name | EMILY ROSE KOLLER MD
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Gender | Female
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Dates
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Enumeration Date | 03/24/2025
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 2900 W OKLAHOMA AVE
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City | MILWAUKEE
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State | WI
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Zip | 53215-4330
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Country | US
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Telephone | 414-649-3323
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Fax | 414-649-5158
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Provider Business Mailing Address
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Address Line | 8631 LUDINGTON CT
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City | WAUWATOSA
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State | WI
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Zip | 53226-2719
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Country | US
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Telephone | 914-582-3940
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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