Individual
NICOLETTE DEVENEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2350 N LAKE DR, SUITE 504, MILWAUKEE, WI 53211-4528
(414) 289-9668
(414) 289-0974
Mailing address
4425 N PORT WASHINGTON RD, GLENDALE, WI 53212-1082
(414) 326-2218
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
TP
KY
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
Primary
54414
WI
Other
Enumeration date
04/11/2008
Last updated
09/25/2015
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