MANDI LYNNE MARONN (NPI# 1619046026) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619046026 |
| Entity Type | Individual |
| Full Name | MANDI LYNNE MARONN |
| Credential | MD |
| Practice Address |
16985 W Bluemound Rd Brookfield WI 53005-5909 |
| Mailing Address |
3003 W Good Hope Rd Milwaukee WI 53209-2042 |
| Practice Telephone | 2626418400 |
| Mailing Telephone | 2625326906 |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2014-10-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 48358 | WI | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | M8812 | TX | Allopathic & Osteopathic Physicians |
| N | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
M8812 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 194427405 | 05 |
| Street Address |
16985 W BLUEMOUND RD |
| City | BROOKFIELD |
| State | WI |
| Zip Code | 53005-5909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649233255 | Niel A Johnson | Emergency Medicine | 16985 W Bluemound Rd, Brookfield, WI 53005-5909 | 2006-04-07 |
| 1831701150 | Dawn Marie Petrovick | Massage Therapist | 16985 W Bluemound Rd, Brookfield, WI 53005-5909 | 2020-08-18 |
| 1760018246 | Richard Harold Labott | Pharmacist | 16985 W Bluemound Rd, Brookfield, WI 53005-5909 | 2020-03-17 |
| 1780242321 | Patti Lynn Hahn | Physical Therapist | 16985 W Bluemound Rd, Brookfield, WI 53005-5909 | 2019-05-30 |
| 1710468251 | Mary Drosen | Physical Therapist | 16985 W Bluemound Rd, Brookfield, WI 53005-5909 | 2018-08-23 |
| 1770029290 | Daryl Schmidt | Physical Therapist | 16985 W Bluemound Rd, Brookfield, WI 53005-5909 | 2017-01-08 |
| 1093170144 | Robert W Reinke | Specialist/Technologist | 16985 W Bluemound Rd, Brookfield, WI 53005-5909 | 2015-12-16 |
| 1518353283 | Diana Vu | Pediatrics | 16985 W Bluemound Rd, Brookfield, WI 53005 | 2015-04-09 |
| 1962896316 | Trent J Meltzer | Pediatrics | 16985 W Bluemound Rd, Brookfield, WI 53005-5909 | 2015-03-24 |
| 1790177681 | Jessica Ferge | Physician Assistant | 16985 W Bluemound Rd, Brookfield, WI 53005-5909 | 2015-03-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154937621 | Nsk Precision Healing & Wellness | Acupuncturist | 17040 W. Greenfield Ave #6, Brookfield, WI 53005 | 2020-09-21 |
| 1033772124 | Dbt Consultants LLC | Social Worker | 200 S. Executive Drive, Ste. 101, Brookfield, WI 53005 | 2019-04-15 |
| 1780142588 | Ashley Wing | Registered Nurse | 405 Bishops Way, Apt 555, Brookfield, WI 53005 | 2019-03-11 |
| 1407370398 | Tombolo, LLC | Clinic/Center | 12545 W. Burleigh Rd., Suite 10, Brookfield, WI 53005 | 2017-08-01 |
| 1720509045 | Rss William Conner LLC | Dentist | 15455 W Bluemound Rd Ste 250, Brookfield, WI 53005 | 2017-06-28 |
| 1669926598 | Mackenzie Rondeau | Physical Therapist | 1905 N Calhoun Rd Ste 105, Brookfield, WI 53005 | 2016-08-09 |
| 1699159319 | Charles Alan Kass | Dentist | 12720 W. North Avenue, Brookfield, WI 53005 | 2015-07-13 |
| 1164804274 | Mary-catherine Nimphius | Counselor | 250 S. Sunny Slope Rd, #128, Brookfield, WI 53005 | 2015-06-25 |
| 1528447034 | Weighless Md, LLC | Dietitian, Registered | 14960 W. Greenfield Ave Suite 104, Brookfield, WI 53005 | 2015-05-29 |
| 1366837346 | Maegan Michelle Cook | Dentist | 13780 W Greenfield Ave Ste 780, Brookfield, WI 53005 | 2015-04-06 |
| Find all providers in zip 53005 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225411481 | Gabriela A Maloney | Dermatology | 17100 W North Ave Ste 200, Brookfield, WI 53005-4489 | 2015-07-07 |
| 1568882793 | Kassandra E Holzem | Dermatology | 195 Discovery Dr, Brookfield, WI 53045 | 2014-04-28 |
| 1184601122 | James L. Troy | Dermatology | 12805 W Burleigh Rd, Suite 200, Brookfield, WI 53005-3111 | 2005-12-30 |
| 1740267780 | Melanie K. Trevino | Dermatology | 12805 W Burleigh Road, Suite 200, Brookfield, WI 53005-3156 | 2005-12-30 |
| 1407849011 | Affiliated Dermatologists Sc | Dermatology | 13800 W North Ave, Suite 100, Brookfield, WI 53005-4974 | 2005-08-30 |
| 1629430210 | Nicholas James Zajdel | Dermatology | 13800 W North Ave Ste 100, Brookfield, WI 53005-4977 | 2016-03-23 |
| 1629395348 | Steven M Schuckit | Dermatology | 13800 W North Ave Ste 100, Brookfield, WI 53005-4977 | 2010-04-21 |
| 1912239658 | Leah Toppel Nelson | Dermatology | 13800 W North Ave Ste 100, Brookfield, WI 53005-4977 | 2010-02-05 |
| 1427121979 | Sun Young Ruggeri | Dermatology | 13800 W North Ave, Ste 100, Brookfield, WI 53005-4974 | 2006-11-15 |
| 1992881361 | Mareshia G Motarjeme | Dermatology | 17100 W North Ave, Suite 200, Brookfield, WI 53005 | 2006-10-28 |
| Find all providers in BROOKFIELD | ||||
| City | BROOKFIELD |
| Zip Code | 53005 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.