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NPI Code Detail

MEDICARE: MS. COLLEEN KELLY WEHMEYER NP

MEDICARE: MS. COLLEEN KELLY WEHMEYER NP
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
1363L00000XNurse Practitioner101482-030WI

General Provider Information

NPI Number : 1750594917
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. COLLEEN KELLY WEHMEYER NP
Provider Business Mailing Address
First Line : W138N6555 MANOR HILLS BLVD
Second Line :
City : MENOMONEE FALLS
State : WI
Zip : 53051-6000
Country : US
Telephone Number : 262-565-8029
Fax Number :
Provider Business Practice Location Address
First Line : 302 N JACKSON ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53202-5904
Country : US
Telephone Number : 414-271-8045
Fax Number : 414-431-0185
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2007
Last Update Date : 06/11/2013

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