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Individual

MS. JULIE PRUETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
9200 W WISCONSIN AVE, NEOPLASTIC DISEASES, MILWAUKEE, WI 53226-3522
(414) 805-8927
(414) 805-6815
Mailing address
9200 W WISCONSIN AVE, NEOPLASTIC DISEASES, MILWAUKEE, WI 53226-3522
(414) 805-8927
(414) 805-6815

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
148831
WI
363LA2100X
Acute Care Nurse Practitioner
Primary
148831
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
039906261M
HUMANA
05
1174575864
WI
Enumeration date
05/17/2006
Last updated
10/01/2020
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