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Organization

THOUSAND MILE JOURNEY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANNE ANIA PERSON FNP (PRESIDENT)
(414) 543-3333
Entity
Organization

Contact information

Practice address
10501 W RESEARCH DRIVE, SUITE G200, MILWAUKEE, WI 53226-3444
(414) 543-3333
(414) 302-1040
Mailing address
10501 W RESEARCH DR, SUITE G200, MILWAUKEE, WI 53226-3449
(414) 543-3333
(414) 302-1040

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
363LF0000X
Family Nurse Practitioner
Primary
3110-33
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1699159962
WI
Enumeration date
07/16/2015
Last updated
03/22/2016
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