MEDICARE: DANITA CHAMPION

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1861296147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANITA CHAMPION

Provider Business Mailing Address
First Line	:	3952 N 82ND STREET
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53222
Country	:	US
Telephone Number	:	414-295-1213
Fax Number	:	414-295-1213

Provider Business Practice Location Address
First Line	:	3952 N 82ND
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53222
Country	:	US
Telephone Number	:	414-295-1213
Fax Number	:	414-295-1213

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

Provider Enumeration Date	:	04/03/2025
Last Update Date	:	01/07/2026

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Directions to “ DANITA CHAMPION ” Practice Location

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