Individual
AUTUMN D UNREIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2424 S 90TH ST FL 2, WEST ALLIS, WI 53227-2455
(414) 328-8777
(414) 328-8110
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10825
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100161117
—
WI
Enumeration date
03/29/2021
Last updated
04/03/2024
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