Provider Demographics
NPI:1366789752
Name:CALLAHAN, MARGANNE ELIZABETH (RN)
Entity type:Individual
Prefix:MS
First Name:MARGANNE
Middle Name:ELIZABETH
Last Name:CALLAHAN
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 1:2605 N UNIVERSITY DR
Mailing Address - Street 2:APT C
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-1408
Mailing Address - Country:US
Mailing Address - Phone:262-945-9545
Mailing Address - Fax:
Practice Address - Street 1:6580 S 46TH ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-8153
Practice Address - Country:US
Practice Address - Phone:414-421-0276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-06
Last Update Date:2013-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI187203-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse