Wiemiller, Mary Jo P

Wiemiller, Mary Jo P is an individual health care provider with primary practice located at 945 N 12Th St , Milwaukee WI 53233-1305. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Wiemiller, Mary Jo P can be contacted via phone (414) 219-7880.

Contact Information

Primary practice address
945 N 12Th St Milwaukee WI 53233-1305
Phone: (414) 219-7880
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 1621 Wisconsin

Profile Details

NPI number 1689628703
LBN Legal business name Wiemiller, Mary Jo P
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2006
Last updated Dec 29th, 2021 - about 4 years ago

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 1689628703 NPPES
Other 006806261B HUMANA
MEDICAID 41975200 HUMANA

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