Basic Information
Provider Information
NPI: 1740683036
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHUSTER
FirstName: MONICA
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: APNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: CALVIN
OtherFirstName: MONICA
OtherMiddleName: L
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 4555 W SCHROEDER DR
Address2: SUITE 170
City: MILWAUKEE
State: WI
PostalCode: 532231475
CountryCode: US
TelephoneNumber: 4143653210
FaxNumber: 4143653225
Practice Location
Address1: 1625 COLDWATER CREEK DR
Address2:  
City: WAUKESHA
State: WI
PostalCode: 531888028
CountryCode: US
TelephoneNumber: 2625218800
FaxNumber: 2625218870
Other Information
ProviderEnumerationDate: 10/01/2014
LastUpdateDate: 10/01/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X5733-33WIY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home