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NPI Code Detail

MEDICARE: ANNA M MLODIK RN

MEDICARE: ANNA M MLODIK RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse109470WI

General Provider Information

NPI Number : 1326396953
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA M MLODIK RN
Provider Business Mailing Address
First Line : 1825 N PROSPECT AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53202-1933
Country : US
Telephone Number : 414-298-7860
Fax Number : 414-298-7882
Provider Business Practice Location Address
First Line : 1825 N PROSPECT AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53202-1933
Country : US
Telephone Number : 414-298-7860
Fax Number : 414-298-7882
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2012
Last Update Date : 09/05/2012

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