Provider Demographics
NPI:1215520028
Name:DJURIC, MAJA (RN)
Entity type:Individual
Prefix:
First Name:MAJA
Middle Name:
Last Name:DJURIC
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4986 S 92ND ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53228-3503
Mailing Address - Country:US
Mailing Address - Phone:414-870-3381
Mailing Address - Fax:
Practice Address - Street 1:1000 NORTHVIEW RD
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1617
Practice Address - Country:US
Practice Address - Phone:262-797-9558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI251418-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse