Individual ProviderMindy A GanskePhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2901 W Kinnickinnic River Pkwy, Suite 102, Milwaukee, WI 53215-3677(414) 384-6700PECOS EnrollmentBased on the most recent information from CMS, provider Mindy A Ganske does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:26 AM.Profile DetailsProvider ID1194916155Provider TypeIndividualFull NameGanske, Mindy ACredentialP.A.GenderFemaleSole ProprietorNoEnumeration Date8/6/2007Last Updated8/6/2007Contact InformationPractice LocationPractice Address2901 W Kinnickinnic River Pkwy, Suite 102, Milwaukee, WI 53215-3677Phone(414) 384-6700Fax(414) 384-3008Mailing LocationMailing Address2901 W Kinnickinnic River Pkwy, Suite 102, Milwaukee, WI 53215-3677Phone(414) 384-6700Fax(414) 384-3008Provider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense2175-023Wisconsin