Individual
MARCIA ANN MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5057 N 19TH ST, MILWAUKEE, WI 53209-5762
(414) 716-5971
(414) 716-5109
Mailing address
5057 N 19TH ST, MILWAUKEE, WI 53209-5762
(414) 716-5971
(414) 716-5109
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
323472-31
WI
251J00000X
Nursing Care Agency
—
—
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
08/27/2018
Last updated
10/20/2021
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