NPI 1073504593 · live from the CMS NPI Registry
Mary E Fazio, R.N.
Registered Nurse, Pediatric Oncology in Shorewood, WI. National Provider Identifier 1073504593, active.
NPI record
| NPI | 1073504593 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Registered Nurse, Pediatric Oncology 163WP0218X |
| Practice location | 4520 N Ardmore Ave, Shorewood, WI 53211 |
| Practice phone | 414-870-4121 |
| Enumerated | November 3, 2005 |
| Last updated | July 13, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse, Home Health | 163WH0200X | 103747-030 (WI) |
| Registered Nurse, Hospice | 163WH1000X | 103747-030 (WI) |
| Registered Nurse, Pediatrics | 163WP0200X | 103747-030 (WI) |
| Registered Nurse, Pediatric Oncology primary | 163WP0218X | 103747-030 (WI) |
| Registered Nurse, Oncology | 163WX0200X | 103747-030 (WI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.