Individual
ANNESSA F RETLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
6308 8TH AVE, KENOSHA, WI 53143-5031
(414) 290-6720
(414) 290-6755
Mailing address
111 E WISCONSIN AVE, SUITE 2000, MILWAUKEE, WI 53202-4815
(414) 290-6720
(414) 290-6755
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
154719-30
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00940026
MEDICARE RAILROAD
WI
Enumeration date
07/29/2010
Last updated
12/27/2021
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