Active NPI
Maryann McKenna Moon, R.N. C.N.S.
- Nurse Practitioner
- Milwaukee, WI
National Provider Identifier
1023455862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 6944
- Practice address
- 9200 W Wisconsin Ave
Milwaukee, WI 53226-3522 - Phone
- (414) 805-8700
- Fax
- (414) 259-1522
- NPI assigned
- Jun 3, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 6944 | WI | Primary |
Addresses
Primary practice location
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Mailing address
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-8700
Other names 1
- Miss Mary Ann McKenna
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Specialist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524700800000",
"number": "1023455862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9200 W WISCONSIN AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532263522",
"telephone_number": "414-805-8700",
"fax_number": "414-259-1522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9200 W WISCONSIN AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532263522",
"telephone_number": "414-805-8700",
"fax_number": "414-259-1522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOON",
"first_name": "MARYANN",
"middle_name": "MCKENNA",
"name_prefix": "Mrs.",
"credential": "R.N. C.N.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-03",
"last_updated": "2018-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "6944",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "MCKENNA",
"middle_name": "ANN",
"prefix": "MISS",
"credential": "R.N.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.