Individual
MR. BENJAMIN THIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-7040
(414) 955-0175
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-7040
(414) 955-0175
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
17073430
WI
363LF0000X
Family Nurse Practitioner
Primary
15166
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689982043
—
WI
Enumeration date
09/20/2010
Last updated
04/01/2024
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