Individual
MS. NANCY J ETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9000 W WISCONSIN AVE, PEDIATRIC NEUROSURGERY, MILWAUKEE, WI 53226-4874
(414) 266-6435
(414) 955-0131
Mailing address
9000 W WISCONSIN AVE, PEDIATRIC NEUROSURGERY, MILWAUKEE, WI 53226-4874
(414) 266-6435
(414) 955-0131
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
298
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000011354
HUMANA
—
05
—
1053362947
—
WI
Enumeration date
05/15/2006
Last updated
12/19/2012
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