Individual
AMY A MEDRANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
5404 W LOOMIS RD, GREENDALE, WI 53129-1411
(630) 571-8990
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10922-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100185852
—
WI
Enumeration date
05/21/2021
Last updated
11/17/2024
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