Individual
MAHITA L GONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
840 N 87TH ST, MILWAUKEE, WI 53226-3586
(414) 805-2018
(414) 461-3553
Mailing address
840 N 87TH ST, MILWAUKEE, WI 53226-3586
(414) 805-2018
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
142515-030
WI
363LF0000X
Family Nurse Practitioner
9999-999
WI
363LP2300X
Primary Care Nurse Practitioner
Primary
4421-33
WI
Other
Enumeration date
05/02/2011
Last updated
05/30/2023
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