Individual
MRS. NANCY RUTH MACZKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADULT PMHNP
Contact information
Practice address
1244 WISCONSIN AVE, SUITE 300, RACINE, WI 53403-1987
(262) 687-2219
Mailing address
1244 WISCONSIN AVE, SUITE 300, RACINE, WI 53403-1987
(262) 687-2219
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2081-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36038300
—
WI
Enumeration date
06/05/2007
Last updated
02/07/2011
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