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NPI Code Detail

MEDICARE: SUSANA TRAJANO CASTILLO RN

MEDICARE: SUSANA TRAJANO CASTILLO 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
1163WR0400XRehabilitation Registered Nurse90716WI

General Provider Information

NPI Number : 1598774804
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSANA TRAJANO CASTILLO RN
Provider Business Mailing Address
First Line : 4950 N WOODBURN ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53217-6065
Country : US
Telephone Number : 414-962-1789
Fax Number :
Provider Business Practice Location Address
First Line : 5000 W NATIONAL AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53295-0001
Country : US
Telephone Number : 414-384-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2006
Last Update Date : 07/08/2007

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