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NPI 1760236608

NPI 1760236608 : SAMANTHA FALKOWSKI RN, BSN, CPN : MILWAUKEE, WI

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General NPI Number Information
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    NPI Number           |    1760236608
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    Entity Type          |    Individual 
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    Provider Name        |    SAMANTHA FALKOWSKI RN, BSN, CPN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/16/2024
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    Last Update Date     |    04/16/2024
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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            |    414-534-6798
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3570 S 82ND ST 
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    City                 |    MILWAUKEE
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    State                |    WI
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    Zip                  |    53220-1024
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    Country              |    US
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    Telephone            |    414-534-6798
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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       |    196293-30
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    License Number State |    WI
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