Organization · Type 2 NPI
Mediverse Health & Wellness LLC
Primary Care Nurse Practitioner · Baldwin, WI
NPI number
1750206496
Active
Practice location
2570 Gracie Dr Ste 107
Baldwin, WI 54002-4403
Fax (715) 487-3131
Mailing address
W4401 State Road 29
Spring Valley, WI 54767-8311
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Infusion Therapy Clinic/Center | 261QI0500X | None listed |
| Primary Care Clinic/Center | 261QP2300X | None listed |
| Primary Care Nurse Practitioner Primary | 363LP2300X | None listed |
Primary Care Nurse Practitioner: Definition to come...
Another provider at this address
About NPI 1750206496
Mediverse Health & Wellness LLC's National Provider Identifier is 1750206496, issued on Aug 11, 2026. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Baldwin, WI. The record was last updated on Aug 11, 2026.