Organization
WISCONSIN HEALTHCARE FAMILY PRACTICES AND BEHAVIORAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENYA ROBERTSON (FNP-BC, PMHNP-BC)
(414) 219-9420
Entity
Organization
Contact information
Practice address
10721 W CAPITOL DR STE G103, WAUWATOSA, WI 53222-1210
(414) 219-9420
(414) 909-8674
Mailing address
10721 W CAPITOL DR STE G103, WAUWATOSA, WI 53222-1210
(414) 219-9420
(414) 909-8674
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
09/17/2020
Last updated
09/17/2020
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