MRS. THERESA SUE IGNACZAK BULLIS (NPI# 1871041996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1871041996 |
Entity Type | Individual |
Full Name | MRS. THERESA SUE IGNACZAK BULLIS |
Credential | CPNP-PC |
Practice Address |
4855 S Moorland Rd New Berlin WI 53151-7494 |
Mailing Address |
9000 W Wisconsin Ave # Ms 958 Milwaukee WI 53226-4874 |
Practice Telephone | 2624327599 |
Practice Fax Number | 2624327694 |
Mailing Telephone | 4142667615 |
Mailing Fax Number | 4142666238 |
Enumeration Date | 2016-09-18 |
Last Update Date | 2018-12-17 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
7248-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | 1871041996 | 05 |
Street Address |
4855 S MOORLAND RD |
City | NEW BERLIN |
State | WI |
Zip Code | 53151-7494 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649277278 | Daniel Dorrington | Pediatrics | 4855 S Moorland Rd, Suite 150, New Berlin, WI 53151-7401 | 2005-06-28 |
1497226781 | Brian Hoppe | Pharmacist | 4855 S Moorland Rd, New Berlin, WI 53151-7494 | 2018-12-11 |
1508229949 | Eman Abdel-latief | Pediatrics | 4855 S Moorland Rd, New Berlin, WI 53151-7494 | 2016-04-02 |
1861863920 | Molly Schuelke | Physician Assistant | 4855 S Moorland Rd, New Berlin, WI 53151-7494 | 2015-10-15 |
1700256781 | Karla Michelle Quinones | Audiologist | 4855 S Moorland Rd, Suite 300, New Berlin, WI 53151-7494 | 2015-10-02 |
1104211416 | Regina Shea Dalla Riva | Pediatrics | 4855 S Moorland Rd, New Berlin, WI 53151-7494 | 2015-04-02 |
1669861548 | Davietta Butty | Pediatrics | 4855 S Moorland Rd, New Berlin, WI 53151 | 2015-01-15 |
1306253117 | Elizabeth Frantal | Physician Assistant | 4855 S Moorland Rd, #150, New Berlin, WI 53151-7494 | 2014-07-14 |
1518371541 | Chasity T Brimeyer | Psychologist | 4855 S Moorland Rd, Headache Clinic, New Berlin, WI 53151-7494 | 2014-06-18 |
1588082028 | Apoorva Prasanna Murthy | Pediatrics | 4855 S Moorland Rd, New Berlin, WI 53151-7494 | 2014-04-02 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629527486 | Natural Look Salon and Wigs LLC | Durable Medical Equipment & Medical Supplies | 4805 S. Moorland Rd, New Berlin, WI 53151 | 2016-09-22 |
1396193033 | New Berlin Medical Services, LLC | Clinic/Center | 15324 W Beloit Road, New Berlin, WI 53151 | 2016-06-02 |
1063899680 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 15300 West Grange Avenue, New Berlin, WI 53151 | 2015-05-04 |
1871970368 | Mary Spath | Physical Therapy Assistant | 2810 South Acredale Road, New Berlin, WI 53151 | 2015-05-04 |
1669885471 | Wauwatosa Prescription Center, Inc. | Pharmacy | 4855 S Moorland Road, New Berlin, WI 53151 | 2014-06-09 |
1750711446 | Pure Family Chiropractic LLC | Chiropractor | 3504 S. Moorland Road, New Berlin, WI 53151 | 2013-11-18 |
1336578202 | Hamilton John Dowden | Chiropractor | 3504 S Moorland Rd, New Berlin, WI 53151 | 2013-11-01 |
1053653618 | Danielle Lynn Lucio | Acupuncturist | 15807 W. National Ave., New Berlin, WI 53151 | 2013-03-21 |
1306195110 | Marlena J Friedrich | Registered Nurse | 1709 S. 171st Street, New Berlin, WI 53151 | 2012-09-07 |
1548519176 | Patricia M Friedrich | Licensed Practical Nurse | 1709 So. 171st Street, New Berlin, WI 53151 | 2012-08-29 |
Find all providers in zip 53151 |
Taxonomy Code | 363LP0200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Pediatrics |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639685274 | Laura Palmer | Nurse Practitioner | 4855 S Moorland Rd # Rod, New Berlin, WI 53151-7494 | 2017-12-19 |
1689878092 | Kathleen Trier Mcwey | Nurse Practitioner | 3610 Michelle Witmer Memorial Dr, New Berlin, WI 53151-5292 | 2007-06-12 |
1013525096 | Katherine Ciminelli Waller | Nurse Practitioner | 4855 S Moorland Rd Fl 3, New Berlin, WI 53151-7494 | 2020-07-16 |
1881057065 | Anna B Pokrzywinski | Nurse Practitioner | 4855 S Moorland Rd Fl 3, New Berlin, WI 53151-7494 | 2016-04-04 |
1922314269 | Alisa A Nehls | Nurse Practitioner | 4855 S Moorland Rd, New Berlin, WI 53151 | 2010-08-24 |
1386979193 | Julie Bolha | Nurse Practitioner | 4855 S Moorland Rd, New Berlin, WI 53151-7494 | 2009-10-13 |
1407966898 | Jodi O Spahr | Nurse Practitioner | 4855 S Moorland Rd Ste 250, New Berlin, WI 53151-7494 | 2006-08-30 |
1205857364 | Meghan C. Belongia | Nurse Practitioner | 4855 S Moorland Rd, New Berlin, WI 53151-7494 | 2006-07-22 |
1063466191 | Julie Ann Averbeck | Nurse Practitioner | 4855 S Moorland Rd, Suite 150, New Berlin, WI 53151-7494 | 2006-05-22 |
1841242443 | Jeanne E Conner | Nurse Practitioner | 4855 S Moorland Rd, Allergy and Immunology, New Berlin, WI 53151-7494 | 2006-05-16 |
Find all providers in NEW BERLIN |
City | NEW BERLIN |
Zip Code | 53151 |
Please comment or provide details below to improve the information on MRS. THERESA SUE IGNACZAK BULLIS.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.