Individual
ROSE M VIDMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, APNP, AGPCNP-BC
Contact information
Practice address
W175N11163 STONEWOOD DR STE 105, GERMANTOWN, WI 53022-6501
(414) 759-4632
Mailing address
N90W16620 ROOSEVELT DR, MENOMONEE FALLS, WI 53051-2166
(414) 759-4632
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
7363-33
WI
363LG0600X
Gerontology Nurse Practitioner
7363-33
WI
363LP2300X
Primary Care Nurse Practitioner
7363-33
WI
Other
Enumeration date
10/26/2016
Last updated
07/22/2025
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