Provider Demographics
NPI:1548816085
Name:NAUMAN, MICHELLE ANN (PT, DPT)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANN
Last Name:NAUMAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10598 W CORTEZ CIR APT 31
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-1576
Mailing Address - Country:US
Mailing Address - Phone:847-454-5765
Mailing Address - Fax:
Practice Address - Street 1:1320 S GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53406-4402
Practice Address - Country:US
Practice Address - Phone:262-886-3431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-12
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist