Individual
EMILY MARIE GHANEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
144 E SUMMIT AVE, WALES, WI 53183-9546
(262) 968-6161
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8328
WI
363LF0000X
Family Nurse Practitioner
8328-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100081427
—
WI
01
—
8328-33
ADVANCED PRACTICE NURSE PRESCRIBER (APNP) LICENSE NUMBER
WI
Enumeration date
08/24/2018
Last updated
05/07/2024
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