Individual
ALYSSA PROFITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2900 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4330
(414) 649-6000
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 649-6000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
7965-33
WI
363LA2100X
Acute Care Nurse Practitioner
7965-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740709708
—
WI
Enumeration date
09/11/2017
Last updated
12/01/2021
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