Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 3833 | WI |
N | 363LP2300X | Nurse Practitioner - Primary Care | 3833-33 | WI |
NPI | 1003149295 |
---|---|
Provider Name | Mrs. Anne E B Lakatos |
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 | 07/09/2009 |
Last Update Date | 04/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003149295 | (05) | WI |