| Wisconsin Healthcare Family Practices And Behavioral Services Llc | |
|
10721 W Capitol Dr Ste G103 Wauwatosa WI 53222-1210 | |
| (414) 219-9420 | |
| (414) 909-8674 |
| Full Name | Wisconsin Healthcare Family Practices And Behavioral Services Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 10721 W Capitol Dr Ste G103, Wauwatosa, Wisconsin |
| Authorized Official Name and Position | Kenya Robertson (FNP-BC, PMHNP-BC) |
| Authorized Official Contact | 4142199420 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wisconsin Healthcare Family Practices And Behavioral Services Llc 10721 W Capitol Dr Ste G103 Wauwatosa WI 53222-1210 Ph: (414) 219-9420 | Wisconsin Healthcare Family Practices And Behavioral Services Llc 10721 W Capitol Dr Ste G103 Wauwatosa WI 53222-1210 Ph: (414) 219-9420 |
| NPI Number | 1003422726 |
|---|---|
| Provider Enumeration Date | 09/17/2020 |
| Last Update Date | 09/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003422726 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Secondary |
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