Basic Information
| Provider Information | |||||||||
| NPI: | 1700139631 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ATKOCAITIS | ||||||||
| FirstName: | MARIE | ||||||||
| MiddleName: | LOUISE | ||||||||
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| Credential: | LPN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3113 EAST WASHINGTON AVE | ||||||||
| Address2: | MADISON HEALTH SERVICES | ||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537044330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6082420220 | ||||||||
| FaxNumber: | 6082421166 | ||||||||
| Practice Location | |||||||||
| Address1: | 3113 EAST WASHINGTON AVE | ||||||||
| Address2: | MADISON HEALTH SERVICES | ||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537044330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6082420220 | ||||||||
| FaxNumber: | 6082421166 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2012 | ||||||||
| LastUpdateDate: | 10/16/2012 | ||||||||
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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 | 164W00000X | 303842-31 | WI | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.