1558445197 NPI number — SE PROFESSIONALS SC

Table of content: ANGELA MURLENE OROZCO FNP (NPI 1225866973)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558445197 NPI number — SE PROFESSIONALS SC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SE PROFESSIONALS SC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558445197
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/31/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8693 N PORT WASHINGTON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FOX POINT
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53217
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
414-351-2020
Provider Business Mailing Address Fax Number:
414-351-2031

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8693 N PORT WASHINGTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FOX POINT
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-351-2020
Provider Business Practice Location Address Fax Number:
414-351-2031
Provider Enumeration Date:
10/24/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
AYMOND
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
KING
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
920-467-7000

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)