Individual
ANDREA R ENTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
N54W23859 JOHANSSEN CT, SUSSEX, WI 53089-2142
(414) 708-8824
Mailing address
N54W23859 JOHANSSEN CT, SUSSEX, WI 53089-2142
(414) 708-8824
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5987
WI
363LA2200X
Adult Health Nurse Practitioner
5987
WI
363LG0600X
Gerontology Nurse Practitioner
Primary
5987
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100040273
—
WI
Enumeration date
09/09/2014
Last updated
08/05/2024
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