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Individual

AMY JO ROANHOUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
801 E SUNSET DR, WAUKESHA, WI 53189-7816
(262) 532-3691
Mailing address
5916 N RIVER BAY RD, WATERFORD, WI 53185-3035
(262) 470-5089

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
11516-33
WI
363LF0000X
Family Nurse Practitioner
Primary
11516-33
WI

Other

Enumeration date
02/01/2022
Last updated
09/25/2023
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