Individual
MS. JANICE MARY THEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-3482
Mailing address
9301 S 96TH ST, FRANKLIN, WI 53132-9518
(414) 425-5115
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
3078-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007000382-28
BOARD CERTIFICATION #
WI
01
—
3078-33
STATE NURSE PRESCRIBER
WI
01
—
85300-30
RN LICENSE
WI
Enumeration date
04/12/2007
Last updated
03/07/2023
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