Wisconsin Healthcare Family Practices and Behavioral Services LLC

NPI #1003422726 in Wauwatosa, Wisconsin

Provider Information

NPI Number: 1003422726
Entity Type: Organization
Organization Name: Wisconsin Healthcare Family Practices and Behavioral Services LLC
Primary Specialty: Clinic/Center - Primary Care
Enumeration Date: Sep 17, 2020
Last Updated: Sep 17, 2020

Practice Location

Address: 10721 W CAPITOL DR STE G103
City: Wauwatosa
State: Wisconsin
ZIP Code: 53222-1210
Phone: (414) 219-9420

Authorized Official

Name: KENYA ROBERTSON
Title: FNP-BC, PMHNP-BC
Phone: (414) 219-9420

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health	363LP0808X
Clinic/Center - Primary Care — Primary Care	261QP2300X	Primary

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