Individual
MARIAH M COLLICOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
20611 WATERTOWN RD STE E, WAUKESHA, WI 53186-1871
(629) 014-4502
(262) 901-4451
Mailing address
20611 WATERTOWN RD STE E, WAUKESHA, WI 53186-1871
(629) 014-4502
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
13169-33
WI
363LF0000X
Family Nurse Practitioner
Primary
13169-33
WI
Other
Enumeration date
09/26/2022
Last updated
08/05/2025
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