Maronn, Mandi Lynne
Maronn, Mandi Lynne is an individual health care provider with primary practice located at 16985 W Bluemound Rd , Brookfield WI 53005-5909. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Pediatric Dermatology. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Maronn, Mandi Lynne can be contacted via phone (262) 641-8400.Contact Information
Primary practice address
16985 W Bluemound Rd
Brookfield WI 53005-5909
Phone: (262) 641-8400
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | M8812 | Texas |
| Allopathic & Osteopathic Physicians / Pediatric Dermatology | 207NP0225X | M8812 | Texas |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 48358 | Wisconsin |
Profile Details
| NPI number | 1619046026 |
|---|---|
| LBN Legal business name | Maronn, Mandi Lynne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 7th, 2006 |
| Last updated | Oct 3rd, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619046026 | NPPES |
| Wisconsin | MEDICAID | 100040549 | |
| Wisconsin | MEDICAID | 194427405 |
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