Individual
MS. CANDI HUMPHREYS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9000 W WISCONSIN AVE, PEDIATRIC EMERGENCY MEDICINE, MILWAUKEE, WI 53226-4874
(414) 266-2625
(414) 266-2635
Mailing address
9000 W WISCONSIN AVE, PEDIATRIC EMERGENCY MEDICINE, MILWAUKEE, WI 53226-4874
(414) 266-2625
(414) 266-2635
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
76293-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005006261F
HUMANA
—
05
—
1801840145
—
WI
Enumeration date
05/20/2006
Last updated
02/07/2013
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