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NPI Code Detail

MEDICARE: MS. LUANNE M WIELICHOWSKI APRN BC

MEDICARE: MS. LUANNE M WIELICHOWSKI APRN BC
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 Practitioner2142WI

General Provider Information

NPI Number : 1952384638
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LUANNE M WIELICHOWSKI APRN BC
Provider Business Mailing Address
First Line : 2985 S CHICAGO AVE
Second Line :
City : SOUTH MILWAUKEE
State : WI
Zip : 53172-3133
Country : US
Telephone Number : 414-762-7322
Fax Number : 414-246-3810
Provider Business Practice Location Address
First Line : 2985 S CHICAGO AVE
Second Line :
City : SOUTH MILWAUKEE
State : WI
Zip : 53172-3133
Country : US
Telephone Number : 414-762-7322
Fax Number : 414-246-3810
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2005
Last Update Date : 11/23/2021

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