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General NPI Number Information
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NPI Number | 1902590185
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Entity Type | Individual
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Provider Name | RHANDI N ROBERSON WILLSON APNP, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/08/2023
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 2555 N DR MARTIN LUTHER KING JR DR
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City | MILWAUKEE
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State | WI
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Zip | 53212-2709
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Country | US
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Telephone | 414-372-8080
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Fax | 414-562-8436
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Provider Business Mailing Address
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Address Line | 2555 N DR MARTIN LUTHER KING JR DR
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City | MILWAUKEE
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State | WI
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Zip | 53212-2709
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Country | US
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Telephone | 414-372-8080
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Fax | 414-562-8436
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 172560-30
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 14057-33
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License Number State | WI
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