Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Miss. Mary Kofigah, 10020-33NP

Individual provider Family Nurse Practitioner · NPI 1871122556

Miss. Mary Kofigah, 10020-33NP is a Nurse Practitioner in Milwaukee, Wisconsin. Qualified in 2019, 7 years ago. Practices with Cleanslate Medical Group of Wisconsin SC, a 28-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
7
Licensed in
WI
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

946 N Van Buren St
Milwaukee, WI 53202-3216
Phone: (414) 671-9355
Fax: (888) 376-4067
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 2024001821 (WI)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 1002033 (WI)

Record details

NPI number1871122556
Entity typeIndividual (Type 1)
GenderFemale
Credentials 10020-33NP
Sole proprietorYes
NPI enumeratedApril 5, 2020
Last updated in NPPESMarch 26, 2025
Certification dateMarch 26, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Cleanslate Medical Group Of Wisconsin Sc — 28 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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