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Individual

MRS. TARA LYN WITCZAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APN-BC

Contact information

Practice address
1555 N RIVERCENTER DR, SUITE #206, MILWAUKEE, WI 53212-3981
(414) 272-5623
(414) 272-5617
Mailing address
1555 N RIVERCENTER DR, SUITE #206, MILWAUKEE, WI 53212-3981
(414) 272-5623
(414) 272-5617

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4766-33
WI

Other

Enumeration date
03/14/2012
Last updated
03/14/2012
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