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Individual

ANA VIDIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-6830
(414) 955-6214
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-6830
(414) 955-6214

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
073339-23
NH
363LA2200X
Adult Health Nurse Practitioner
Primary
6267
WI
363LG0600X
Gerontology Nurse Practitioner
6267
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1821481433
WI
05
3105977
NH
Enumeration date
03/06/2015
Last updated
12/13/2018
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