Marlena Anderson, RN

Individual provider Active NPI Registered Nurse · West Allis, WI

NPI 1689412348 · NPPES record last updated Jul 17, 2024

Key facts

NPI
1689412348
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
156115-30 (WI)
Practice address
2814 S 108TH St
West Allis, WI 53227-3224
Phone
(414) 885-3525
NPI assigned
Jul 17, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
156115-30WIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Joyride Transport, LLC Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 156115-30 WI Yes

Addresses

Primary practice location

2814 S 108TH St
West Allis, WI 53227-3224

Mailing address

2814 S 108TH St
West Allis, WI 53227-3224
Phone (414) 651-5954

Other providers in West Allis, WI

All providers in West Allis, WI · Registered Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.