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General NPI Number Information
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NPI Number | 1366035628
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Entity Type | Individual
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Provider Name | HOLLI DRENDEL PH.D., FACMGG
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Gender | Female
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Dates
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Enumeration Date | 02/18/2021
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Last Update Date | 02/18/2021
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Provider Practice Location Address
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Address Line | MEDICAL COLLEGE OF WISCONSIN, WDL BUILDING, RM 208 9200 W. WISCONSIN AVE
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City | MILWAUKEE
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State | WI
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Zip | 53226
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Country | US
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Telephone | 414-805-4862
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Fax |
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Provider Business Mailing Address
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Address Line | 203 N 88TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53226-4615
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Country | US
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Telephone | 515-708-1604
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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 | 170100000X
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Taxonomy Name | Ph.D. Medical Genetics
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License Number |
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License Number State |
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