Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 37905 | WI |
N | 2084N0400X | Neurologist | 37905 | WI |
NPI | 1396796132 |
---|---|
Provider Name | Dr. Wendy L Peltier |
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 | 02/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002000219X | HUMANA (01) | |
1396796132 | (05) | WI |
G36745 | (02) |