Individual
AMANDA HALLQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
21700 INTERTECH DR, BROOKFIELD, WI 53045-5197
(262) 532-8300
Mailing address
4460 N 135TH ST, BROOKFIELD, WI 53005-1224
(262) 370-0239
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8252-33
WI
Other
Enumeration date
03/01/2018
Last updated
03/01/2018
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