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General NPI Number Information
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NPI Number | 1407711682
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Entity Type | Individual
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Provider Name | AVA ELAINE LANDMEYER
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Gender | Female
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Dates
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Enumeration Date | 12/19/2025
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 9000 W WISCONSIN AVE
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City | MILWAUKEE
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State | WI
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Zip | 53226-4874
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Country | US
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Telephone | 414-266-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 165 N ROLLAND RD
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City | BROOKFIELD
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State | WI
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Zip | 53005-3964
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Country | US
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Telephone | 262-219-0056
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 871523
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License Number State |
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