Individual
MS. JOANNE D MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
9200 W WISCONSIN AVE, GENERAL SURGERY, MILWAUKEE, WI 53226-3522
(414) 805-5800
(414) 805-5809
Mailing address
9200 W WISCONSIN AVE, GENERAL SURGERY, MILWAUKEE, WI 53226-3522
(414) 805-5800
(414) 805-5809
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
142757
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962697953
—
WI
Enumeration date
09/12/2007
Last updated
05/05/2014
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