Individual
ALYSSA RAE MATUSZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-AC
Contact information
Practice address
9000 W. WISCONSIN AVE, MS 681, MILWAUKEE, WI 53226
(414) 266-3360
(414) 266-3563
Mailing address
9000 W. WISCONSIN AVE, MS 681, MILWAUKEE, WI 53226
(414) 266-3360
(414) 266-3563
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
179985
WI
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
5928-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093114050
—
WI
Enumeration date
08/15/2014
Last updated
10/02/2015
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