Individual
MISS MOLLY MARIE ULLENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
16655 W BLUEMOUND RD, BROOKFIELD, WI 53005-5957
(414) 257-1708
(414) 257-1787
Mailing address
16655 W BLUEMOUND RD, BROOKFIELD, WI 53005-5957
(414) 257-1708
(414) 257-1787
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
7448
WI
Other
Enumeration date
03/20/2017
Last updated
03/20/2017
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