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Individual

MARISSA VERONICA MEDINA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2201 N CAMBRIDGE AVE, MILWAUKEE, WI 53202-1047
(414) 949-1040
Mailing address
777 N JEFFERSON ST STE 408, MILWAUKEE, WI 53202-3875
(414) 949-1040

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
WI
343900000X
Non-emergency Medical Transport (VAN)
Primary

Other

Enumeration date
08/28/2023
Last updated
03/27/2026
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