Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 3753 | WI |
N | 363LA2200X | Nurse Practitioner - Adult Health | 3753-033 | WI |
NPI | 1003042037 |
---|---|
Provider Name | Michelle J. Rick |
First Address | Milwaukee, WI 53209-2042 |
Second Address | West Allis, WI 53227-2468 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2009 |
Last Update Date | 22/12/2021 |