Individual
NICHOLAS GENGLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-7400
(414) 805-7388
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-7400
(414) 805-7388
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
7004
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639899487
—
WI
Enumeration date
08/31/2022
Last updated
05/04/2023
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