Individual
FREDERICK JACOBUS VAN VUUREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
377 W RIVER WOODS PKWY STE 201, GLENDALE, WI 53212-1088
(414) 323-6880
Mailing address
2500 W MANGOLD AVE, MILWAUKEE, WI 53221-4965
(262) 777-0798
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10598
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10598
NP LICENSE
WI
Enumeration date
07/06/2021
Last updated
08/31/2021
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