Rose M. Vandenzen
Individual provider Active NPI Occupational Therapy Assistant · Appleton, WI
NPI 1124152376 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1124152376
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 1087-27 (WI)
- Practice address
- 2915 N Meade St
Appleton, WI 54911-1509 - Phone
- (920) 831-8711
- NPI assigned
- Mar 16, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1087-27 | WI | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 1087-27 | WI | Yes |
Addresses
Primary practice location
2915 N Meade St
Appleton, WI 54911-1509
Mailing address
2915 N Meade St
Appleton, WI 54911-1509
Phone (920) 831-8711
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40782700 | Medicaid | WI |
Other providers in Appleton, WI
- Zachary Vandenberg
- Leah Eileen Vandenbosch
- Jennifer M Vandeneng
- Samantha Ann Vandenhouten
- Erin R Vandenlangenberg
- Kylie J Vander Hyden
- Drew Vander Velden
- Brianna Rae Vander Zanden
- Maria Vanderlinden
- Traci Vanderloop
All providers in Appleton, WI · Occupational Therapy Assistant in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.