Individual
QUINTA NFOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP-DNP
Contact information
Practice address
12555 W NATIONAL AVE STE 200, NEW BERLIN, WI 53151-4061
(262) 754-2555
(262) 754-2552
Mailing address
12555 W NATIONAL AVE STE 200, NEW BERLIN, WI 53151-4061
(262) 754-2555
(262) 754-2552
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6418-33
WI
Other
Enumeration date
08/10/2015
Last updated
02/19/2024
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