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Individual

AMY B DETZNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
9200 W WISCONSIN AVE, DIVISION OF NEOPLASTIC DISEASES, MILWAUKEE, WI 53226-3522
(414) 805-6800
(262) 798-7701
Mailing address
9200 W WISCONSIN AVE, DIVISION OF NEOPLASTIC DISEASES, MILWAUKEE, WI 53226-3522
(414) 805-6800
(262) 798-7701

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
155334
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1598004921
WI
Enumeration date
02/05/2013
Last updated
09/23/2020
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