Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 4704283211 | MI |
Y | 363LA2100X | Nurse Practitioner - Acute Care | 9076 | WI |
NPI | 1003387143 |
---|---|
Provider Name | Dr. Joy Ikeri |
First Address | Milwaukee, WI 53226-3522 |
Second Address | Milwaukee, WI 53226 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2018 |
Last Update Date | 05/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003387143 | (05) | WI |