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NPI Code Detail

MEDICARE: MARY WESLEY RN

MEDICARE:   MARY  WESLEY  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
1163WH0200XHome Health Registered NurseWI

General Provider Information

NPI Number : 1407815186
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY WESLEY RN
Provider Business Mailing Address
First Line : 4522 N 78TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53218-5306
Country : US
Telephone Number : 414-536-0340
Fax Number : 414-536-0340
Provider Business Practice Location Address
First Line : 4522 N 78TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53218-5306
Country : US
Telephone Number : 414-536-0340
Fax Number : 414-536-0340
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2006
Last Update Date : 07/08/2007

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Directions to “ MARY WESLEY RN” Practice Location

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