Individual
JUDITH ANN EVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1155 N MAYFAIR RD, MILWAUKEE, WI 53226-3462
(262) 366-4441
Mailing address
1155 N MAYFAIR ROAD, THIRD FLOOR, MILWAUKEE, WI 53226-3464
(414) 955-8990
(414) 955-6299
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
7811-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770008492
—
WI
Enumeration date
08/03/2017
Last updated
08/22/2017
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