Individual provider · NPI-1

Robert Agnew Jr., EMT

Emergency Medical Technician, Basic · Milwaukee, WI

NPI number1073363834
StatusActive
Last updated in NPPESMar 25, 2024

Details

NPI
1073363834
Entity type
Individual (NPI-1)
Name
Robert Agnew Jr.
Credential
EMT
Sex
Male
Sole proprietor
Yes
Enumeration date
Mar 25, 2024
Certification date
Mar 25, 2024
Last updated
Mar 25, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
146N00000X Emergency Medical Technician, Basic70117917WIYes

Practice location

3440 N 54th St
Milwaukee, WI 53216-2802

Phone 305-607-5623

Mailing address

2828 N 12th St
Milwaukee, WI 53206-2615

Phone 305-607-5623

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