Theresa L Wycklendt, APNP | |
2514 S 102nd St Ste 160, West Allis, WI 53227-2142 | |
(414) 255-0300 | |
Not Available |
Full Name | Theresa L Wycklendt |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Location | 2514 S 102nd St Ste 160, West Allis, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1538736350 | NPI | - | NPPES |
100174297 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | 11060-033 (Wisconsin) | Primary |
363LC0200X | Nurse Practitioner - Critical Care Medicine | 1716711 (Wisconsin) | Secondary |
Entity Name | Vpa Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1659484657 PECOS PAC ID: 9234041948 Enrollment ID: O20040322000734 |
Mailing Address | Practice Location Address |
---|---|
Theresa L Wycklendt, APNP 3301 W Forest Home Ave, Milwaukee, WI 53215-2843 Ph: (414) 219-2000 | Theresa L Wycklendt, APNP 2514 S 102nd St Ste 160, West Allis, WI 53227-2142 Ph: (414) 255-0300 |
Taranpreet Kaur, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 8901 W Lincoln Ave, West Allis, WI 53227 Phone: 414-328-6000 | |
Paul Facchiano, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 6609 W Greenfield Ave, West Allis, WI 53214 Phone: 414-257-8500 | |
Michelle Cyr, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2514 S 102nd St Ste 160, West Allis, WI 53227 Phone: 414-255-0300 | |
Christina Lindsay, APNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1709 S 70th St, West Allis, WI 53214 Phone: 414-510-9078 | |
Autumn D Unrein, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2424 S 90th St Fl 2, West Allis, WI 53227 Phone: 414-328-8777 Fax: 414-328-8110 | |
Stephanie Schell, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2424 S 90th St Fl 3, West Allis, WI 53227 Phone: 414-328-8270 Fax: 414-328-8275 | |
Katelyn Nieman, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2514 S 102nd St Ste 160, West Allis, WI 53227 Phone: 414-255-0340 Fax: 855-342-0199 |