Individual
MRS. ANDREA F PENISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6901 W EDGERTON AVE, GREENFIELD, WI 53220-4420
(414) 325-5244
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
152943-30
WI
363L00000X
Nurse Practitioner
Primary
8741-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100084017
—
WI
Enumeration date
04/20/2010
Last updated
12/27/2024
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