Provider Demographics
NPI:1528263225
Name:MAUS, MICHAEL KEVIN (RN)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:KEVIN
Last Name:MAUS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 N DREW ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-2108
Mailing Address - Country:US
Mailing Address - Phone:920-740-2668
Mailing Address - Fax:
Practice Address - Street 1:3350 LA JOLLA VILLAGE DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92161-0002
Practice Address - Country:US
Practice Address - Phone:858-552-8585
Practice Address - Fax:858-552-7540
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI127494163WG0600X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WG0600XNursing Service ProvidersRegistered NurseGerontology
Not Answered163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult