Provider Demographics
NPI:1750347811
Name:MAXELL, BARBARA M (R N)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:M
Last Name:MAXELL
Suffix:
Gender:F
Credentials:R N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9109 W ALLERTON AVE
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53228-2833
Mailing Address - Country:US
Mailing Address - Phone:414-321-4794
Mailing Address - Fax:
Practice Address - Street 1:9109 W ALLERTON AVE
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53228-2833
Practice Address - Country:US
Practice Address - Phone:414-321-4794
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI91977-030163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38289100Medicare ID - Type UnspecifiedINDEPENDENT NURSE