Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 42777 | WI |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 42777 | WI |
NPI | 1255382081 |
---|---|
Provider Name | Dr. Nancy E Havas |
First Address | Milwaukee, WI 53226-3522 |
Second Address | Milwaukee, WI 53226-3522 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 17/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1255382081 | (05) | WI |
H47834 | (02) |