Provider Demographics
NPI:1891859591
Name:IULIANO, NANCY M (PT)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:M
Last Name:IULIANO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3497
Mailing Address - Street 2:
Mailing Address - City:STURTEVANT
Mailing Address - State:WI
Mailing Address - Zip Code:53177-0300
Mailing Address - Country:US
Mailing Address - Phone:888-201-1040
Mailing Address - Fax:866-245-8064
Practice Address - Street 1:2717 18TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53140-4666
Practice Address - Country:US
Practice Address - Phone:262-551-5650
Practice Address - Fax:866-245-8064
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2881-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI859400068OtherMEDICARE
WIK400208886Medicare PIN
WI001032455Medicare PIN