Basic Information
| Provider Information | |||||||||
| NPI: | 1376540864 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHLOMER | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | RAE | ||||||||
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| Credential: | MSN, APNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | W380N6009 HIGHWAY 67 | ||||||||
| Address2: | |||||||||
| City: | OCONOMOWOC | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530661634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2625604823 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1185 CORPORATE CENTER DR | ||||||||
| Address2: | SUITE 175 PROHEALTH CARE MEDICAL ASSOCIATES INC | ||||||||
| City: | WAUKESHA | ||||||||
| State: | WI | ||||||||
| PostalCode: | 531885031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2629288400 | ||||||||
| FaxNumber: | 2629288484 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2005 | ||||||||
| LastUpdateDate: | 04/03/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 1056-033 | WI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.