Individual
MADELINE MARIE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
945 N 12TH ST, MILWAUKEE, WI 53233-1305
(414) 219-6777
Mailing address
1343 N 10TH AVE, WEST BEND, WI 53090-1813
(920) 655-1038
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9666-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100094193
—
WI
Enumeration date
10/07/2019
Last updated
10/06/2022
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