Organization · Type 2 NPI

Forward Healthy Lifestyles

Nurse Practitioner · Pewaukee, WI

NPI number 1053263764 Active

Practice location

145 W Wisconsin Ave Unit 3
Pewaukee, WI 53072-3437

Mailing address

N112W15237 Mequon Rd Ste 100
Germantown, WI 53022-3466

Other practice locations

  • 3970 N Oakland Ave Ste 502, Shorewood, WI 53211-2265 · (262) 313-8375

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000XNone listed

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1053263764

Forward Healthy Lifestyles's National Provider Identifier is 1053263764, issued on Feb 13, 2026. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Pewaukee, WI. The record was last updated on Feb 13, 2026.