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General NPI Number Information
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NPI Number | 1952385486
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Entity Type | Individual
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Provider Name | SHERRY L NESS-WENUM M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/29/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | W180N8085 TOWN HALL RD
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-3518
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Country | US
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Telephone | 262-532-3060
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Fax |
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Provider Business Mailing Address
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Address Line | 500 W BROWN DEER RD SUITE 202
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City | BAYSIDE
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State | WI
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Zip | 53217-1618
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Country | US
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Telephone |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 21792
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License Number State | WI
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