Organization
NISA INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAYLA DANIELLE RUBBANI (DIRECTOR)
(262) 412-9728
Entity
Organization
Contact information
Practice address
10213A W FOND DU LAC AVE, 128, MILWAUKEE, WI 53224-5171
(262) 412-9728
Mailing address
P.O. BOX 18488, MILWAUKEE, WI 53218
(262) 412-9728
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/21/2012
Last updated
11/21/2012
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