Mary E Fazio, R.N.

Primary specialty

Pediatric Oncology Registered NurseTaxonomy code 163WP0218X

Practice address

4520 N Ardmore Ave
Shorewood, WI 53211-1401

Phone

(414) 870-4121

Fax

(414) 961-2435

NPI assigned

Nov 3, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1073504593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 N ARDMORE AVE",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532111401",
            "telephone_number": "414-870-4121",
            "fax_number": "414-961-2435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 N ARDMORE AVE",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532111401",
            "telephone_number": "414-870-4121",
            "fax_number": "414-961-2435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZIO",
        "first_name": "MARY",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-03",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0218X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatric Oncology",
            "state": "WI",
            "license": null,
            "primary": true
        },
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "WI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Draver Dental LLC
• Hannah G Draver
• Wilhelmina Duncan, M.S.S.W.
• Stephanie Lynn Emery
• Michelle Fahrnow, MS, LPC-IT
• Klara Fleysh, DDS
• Foot & Ankle Health Center, S.C.
• Marybeth Francis, DMD
• Ailsa Freytag
• Cassandra Gabor, RN

• Registered Nurse in Shorewood, WI
• Providers in Shorewood, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.