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Individual

CARMEN E NOLLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
9200 W WISCONSIN AVE, DEPARTMENT OF EMERGENCY MEDICINE, MILWAUKEE, WI 53226-3522
(414) 805-6450
(414) 805-0880
Mailing address
9200 W WISCONSIN AVE, DEPARTMENT OF EMERGENCY MEDICINE, MILWAUKEE, WI 53226-3522
(414) 805-6450
(414) 805-0880

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2941
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1023371937
WI
Enumeration date
06/18/2012
Last updated
10/01/2020
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