Individual
JOSE M AVILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, MSN, FNP-C
Contact information
Practice address
6030 W OKLAHOMA AVE, MILWAUKEE, WI 53219-4133
(414) 546-2992
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 389-2377
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1406-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43894900
—
WI
Enumeration date
10/04/2005
Last updated
11/18/2021
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