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General NPI Number Information
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NPI Number | 1760111256
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Entity Type | Individual
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Provider Name | CARLA MAE WEISMANTEL APNP
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Gender | Female
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Dates
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Enumeration Date | 06/09/2022
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 5007 S HOWELL AVE STE 350
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City | MILWAUKEE
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State | WI
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Zip | 53207-6159
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Country | US
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Telephone | 262-789-1191
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Fax |
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Provider Business Mailing Address
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Address Line | 665 WINDING WOODS DR
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City | LOVELAND
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State | OH
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Zip | 45140-8080
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Country | US
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Telephone | 513-490-6485
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 1155040
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 14817-33
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License Number State | WI
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