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General NPI Number Information
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NPI Number | 1750594917
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Entity Type | Individual
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Provider Name | COLLEEN KELLY WEHMEYER NP
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Gender | Female
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 06/11/2013
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Provider Practice Location Address
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Address Line | 302 N JACKSON ST
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City | MILWAUKEE
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State | WI
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Zip | 53202-5904
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Country | US
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Telephone | 414-271-8045
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Fax | 414-431-0185
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Provider Business Mailing Address
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Address Line | W138N6555 MANOR HILLS BLVD
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-6000
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Country | US
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Telephone | 262-565-8029
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 101482-030
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License Number State | WI
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