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NPI 1437732740

NPI 1437732740 : LUCIA ELIZABETH BRACCO DO : MILWAUKEE, WI

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General NPI Number Information
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    NPI Number           |    1437732740
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    Entity Type          |    Individual 
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    Provider Name        |    LUCIA ELIZABETH BRACCO DO
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/04/2021
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    Last Update Date     |    04/09/2024
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Provider Practice Location Address
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    Address Line         |    8915 W CONNELL AVE 
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    City                 |    MILWAUKEE
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    State                |    WI
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    Zip                  |    53226-3067
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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         |    8915 W CONNELL AVE 
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    City                 |    MILWAUKEE
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    State                |    WI
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    Zip                  |    53226-3067
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    Country              |    US
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    Telephone            |    414-266-2000
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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        |    208000000X
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    Taxonomy Name        |    Pediatrics Physician
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    License Number       |    125.078207
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    License Number State |    IL
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Taxonomy #2
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    Taxonomy Code        |    208000000X
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    Taxonomy Name        |    Pediatrics Physician
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    License Number       |    036.166451
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    License Number State |    IL
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Taxonomy #3
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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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Taxonomy #4
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    Taxonomy Code        |    208000000X
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    Taxonomy Name        |    Pediatrics Physician
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    License Number       |    81442-21
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    License Number State |    WI
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