O'Donnell, Diane M

O'Donnell, Diane M is an individual health care provider with primary practice located at 1220 Dewey Ave Lorton Building, Wauwatosa WI 53213-2504. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. O'Donnell, Diane M can be contacted via phone (414) 257-7356.

Contact Information

Primary practice address
1220 Dewey Ave Lorton Building Wauwatosa WI 53213-2504
Phone: (414) 257-7356
Fax: (414) 257-7515
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 1020-033 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 74350 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 74350 Wisconsin

Profile Details

NPI number 1952482705
LBN Legal business name O'Donnell, Diane M
Credentials APNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2006
Last updated Mar 7th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952482705 NPPES
Wisconsin MEDICAID 100014190
Wisconsin MEDICAID 439-167-00

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