Provider Demographics
NPI:1063848364
Name:WIRSCHING, TIMOTHY E (APNP)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:E
Last Name:WIRSCHING
Suffix:
Gender:M
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5015 W BURLEIGH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210-1662
Mailing Address - Country:US
Mailing Address - Phone:414-447-2221
Mailing Address - Fax:
Practice Address - Street 1:5015 W BURLEIGH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53210-1662
Practice Address - Country:US
Practice Address - Phone:414-447-2221
Practice Address - Fax:414-874-4507
Is Sole Proprietor?:No
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5474363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily