Basic Information
| Provider Information | |||||||||
| NPI: | 1073099867 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRANCHINI | ||||||||
| FirstName: | MADELINE | ||||||||
| MiddleName: | KAY | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6921 N BELMONT LN | ||||||||
| Address2: | |||||||||
| City: | FOX POINT | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532173612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2245786673 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1032 S CESAR E CHAVEZ DR | ||||||||
| Address2: | |||||||||
| City: | MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532042203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4146721353 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2018 | ||||||||
| LastUpdateDate: | 01/14/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 4462-23 | WI | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.