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General NPI Number Information
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NPI Number | 1376892117
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Entity Type | Individual
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Provider Name | AGNIESZKA DURSKI APN-FNP
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Gender | Female
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Dates
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Enumeration Date | 09/07/2012
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 5404 W LOOMIS RD
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City | GREENDALE
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State | WI
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Zip | 53129-1411
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Country | US
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Telephone | 414-329-4979
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Fax |
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Provider Business Mailing Address
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Address Line | 5404 W LOOMIS RD
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City | GREENDALE
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State | WI
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Zip | 53129-1411
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Country | US
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Telephone | 414-329-4979
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.009505
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 10948
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License Number State | WI
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