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Organization
ARCHWELL HEALTH PROFESSIONAL SERVICES OF WISCONSIN, SC
Active
Organization
ARCHWELL HEALTH PROFESSIONAL SERVICES OF WISCONSIN, SC
Active
Other names
ArchWell Health
Organization subpart
No
Provider details
NPI number
Authorized official
AMY MODDESETTE (SR. DIRECTOR, MANAGED CARE OPS)
(913) 226-8221
Entity
Organization
Contact information
Practice address
2730 N MARTIN LUTHER KING DR, MILWAUKEE, WI 53212-2312
(414) 508-0002
Mailing address
102 WOODMONT BLVD STE 600, NASHVILLE, TN 37205-5250
(888) 987-1151
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
02/24/2025
Last updated
02/03/2026
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