Individual
MAGGIE C FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1220 DEWEY AVE, WAUWATOSA, WI 53213-2504
(414) 773-4312
Mailing address
1220 DEWEY AVE, WAUWATOSA, WI 53213-2504
(414) 773-4312
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
10997-033
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10997-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100176842
—
WI
Enumeration date
06/15/2021
Last updated
08/14/2024
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