Provider Demographics
NPI:1679950513
Name:MACIEJEWSKI, HOLLY BETH (APNP)
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:BETH
Last Name:MACIEJEWSKI
Suffix:
Gender:F
Credentials:APNP
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Mailing Address - Street 1:1111 DELAFIELD ST
Mailing Address - Street 2:215
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-3417
Mailing Address - Country:US
Mailing Address - Phone:262-542-0074
Mailing Address - Fax:262-542-2803
Practice Address - Street 1:1111 DELAFIELD ST
Practice Address - Street 2:215
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-3417
Practice Address - Country:US
Practice Address - Phone:262-542-0074
Practice Address - Fax:262-542-2803
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI6342-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily