MEDICARE: ROSEMARY EDEA UZZI 132809-31

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
1	164W00000X	Licensed Practical Nurse	31250931	WI

General Provider Information

NPI Number	:	1427326958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSEMARY EDEA UZZI 132809-31

Provider Business Mailing Address
First Line	:	5791 W BETTY LN
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53223-2919
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5791 W BETTY LN
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53223-2919
Country	:	US
Telephone Number	:	414-355-5363
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2011
Last Update Date	:	12/12/2011

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