Individual
MAE R MCEWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
12203 CORPORATE PKWY, MEQUON, WI 53092-3388
(262) 387-8202
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4821
WI
363LF0000X
Family Nurse Practitioner
4821
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100022887
—
WI
Enumeration date
04/09/2012
Last updated
05/28/2025
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