Individual
DONNA F ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1020 N 12TH ST FL 4, MILWAUKEE, WI 53233
(414) 219-5000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(414) 773-4312
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3594
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3594
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922245604
—
WI
Enumeration date
01/16/2009
Last updated
10/15/2023
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