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General NPI Number Information
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NPI Number | 1851765911
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Entity Type | Organization
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Legal Business Name | THE HEART MILE JOURNEY
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Dates
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Enumeration Date | 11/30/2015
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Last Update Date | 07/19/2016
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Provider Practice Location Address
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Address Line | 10501 W RESEARCH DR BUILDING G200
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City | MILWAUKEE
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State | WI
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Zip | 53226-3449
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Country | US
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Telephone | 414-543-3333
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Fax |
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Provider Business Mailing Address
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Address Line | 10501 W RESEARCH DR SUITE G200
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City | MILWAUKEE
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State | WI
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Zip | 53226-3449
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Country | US
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Telephone | 414-543-3333
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Fax |
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Authorized Official
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Title or Position | APNP
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Name | ANIA ANNE PERSON
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Credential | NP
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Telephone | 414-543-3333
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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 | 3110
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License Number State | WI
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