Organization
COUNTY OF MILWAUKEE
Active
Other names
Milwaukee County Behavioral Health Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHERI DUQUAINE (PATIENT ACCOUNTS MANAGER)
(414) 391-8172
Entity
Organization
Contact information
Practice address
1220 W VLIET ST FL 3, MILWAUKEE, WI 53205-2117
(414) 257-6995
Mailing address
1220 W VLIET ST FL 3, MILWAUKEE, WI 53205-2117
(414) 257-6995
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000812
MEDICARE PTAN
WI
05
—
32753800
—
WI
Enumeration date
01/03/2007
Last updated
04/13/2023
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