| Doctor Name: | MHARAJOY G SISON |
| NPI Number: | 1336491646 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APNP |
| License Number: | 6717 |
| Business Practice Address: | 2603 W Rawson Ave Suite 128 Oak Creek, WI - 531548422 |
| Business Phone Number: | 4144316760 |
| Business Fax Number: | 4144316761 |
| Mailing Address: | Po Box 639, THIENSVILLE |
| State: | WI |
| Postal Code: | 530920639 |
| Phone Number: | 4142479005 |
| Fax Number: | 4142479004 |
| NPI Enumeration Date: | 10/10/2012 |
| NPI Last Update Date: | 01/05/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 6717 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |