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General NPI Number Information
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NPI Number | 1881998904
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Entity Type | Individual
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Provider Name | JOEL DAVID MALAK RN, APNP
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Gender | Male
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Dates
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Enumeration Date | 01/04/2011
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Last Update Date | 06/28/2025
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Provider Practice Location Address
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Address Line | 290 LYNNE TRL
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City | OREGON
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State | WI
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Zip | 53575-3424
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Country | US
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Telephone | 920-948-2810
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Fax |
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Provider Business Mailing Address
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Address Line | 333 E CAMPUS MALL SUITE NUMBER 6121
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City | MADISON
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State | WI
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Zip | 53715-1365
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Country | US
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Telephone | 608-262-0955
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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 | 163WX0106X
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Taxonomy Name | Occupational Health Registered Nurse
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License Number | 169301-30
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LX0106X
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Taxonomy Name | Occupational Health Nurse Practitioner
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License Number | 16646-33
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License Number State | WI
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