Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 177-033 | WI |
N | 363L00000X | Nurse Practitioner | 87793-030 | WI |
NPI | 1003824665 |
---|---|
Provider Name | Ms. Joyce E Abbott |
First Address | Milwaukee, WI 53215-2843 |
Second Address | Oshkosh, WI 54901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 23/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
43891400 | (05) | WI |