Individual
MRS. ABBY JEAN BANECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-APNP
Contact information
Practice address
9200 W WISCONSIN AVE, DEPARTMENT OF EMERGENCY MEDICINE, MILWAUKEE, WI 53226-3522
(414) 805-6450
(414) 805-6464
Mailing address
9200 W WISCONSIN AVE, DEPARTMENT OF EMERGENCY MEDICINE, MILWAUKEE, WI 53226-3522
(414) 805-6450
(414) 805-6464
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
164005-30
WI
363LF0000X
Family Nurse Practitioner
5737-33
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5737-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225339344
—
WI
Enumeration date
11/05/2010
Last updated
11/09/2024
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