Individual
MS. RANDI J NIEDFELDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9200 W WISCONSIN AVE, DEPARTMENT OF EMERGENCY MEDICINE, MILWAUKEE, WI 53226-3522
(414) 805-6450
(414) 805-6464
Mailing address
9200 W WISCONSIN AVE, DEPARTMENT OF EMERGENCY MEDICINE, MILWAUKEE, WI 53226-3522
(414) 805-6450
(414) 805-6464
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
192
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009006261G
HUMANA
—
05
—
1467406421
—
WI
Enumeration date
05/22/2006
Last updated
11/04/2013
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