Cori Lyn Dynek, RN,BSN

Individual provider Active NPI Home Health Registered Nurse · Hartford, WI

NPI 1124266259 · NPPES record last updated Jan 27, 2009

Key facts

NPI
1124266259
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Registered Nurse 163WH0200X
License
147857-30 (WI)
Practice address
539 Cleveland Ave
Hartford, WI 53027-2729
Phone
(414) 699-9845
NPI assigned
Jan 27, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
147857-30WIMDHome Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 147857-30 WI Yes

Addresses

Primary practice location

539 Cleveland Ave
Hartford, WI 53027-2729

Mailing address

539 Cleveland Ave
Hartford, WI 53027-2729
Phone (414) 699-9845

Other providers in Hartford, WI

All providers in Hartford, WI · Home Health Registered Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.