| Doctor Name: | MS. MARY E FAZIO |
| NPI Number: | 1073504593 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N. |
| License Number: | |
| Business Practice Address: | 4520 N Ardmore Ave Shorewood, WI - 532111401 |
| Business Phone Number: | 4148704121 |
| Business Fax Number: | 4149612435 |
| Mailing Address: | 4520 N Ardmore Ave, SHOREWOOD |
| State: | WI |
| Postal Code: | 532111401 |
| Phone Number: | 4148704121 |
| Fax Number: | 4149612435 |
| NPI Enumeration Date: | 11/03/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WH0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | WI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Home Health |
| Taxonomy Definition: | |