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Individual

MS. ROCHELLE ANN BUMBALEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, MPAS

Contact information

Practice address
2801 W KINNICKINNIC RIVER PKWY, SUITE 345, MILWAUKEE, WI 53215-3669
(414) 649-7900
Mailing address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1176-023
WI
363AS0400X
Surgical Physician Assistant
1176023
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42981200
WI
Enumeration date
02/20/2007
Last updated
11/29/2021
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