Raquel Arenas-Grube

Individual provider Active NPI Licensed Practical Nurse · Appleton, WI

NPI 1124422092 · NPPES record last updated Oct 21, 2014

Key facts

NPI
1124422092
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
316103 (WI)
Practice address
414 N Division St
Appleton, WI 54911-4611
Phone
(920) 445-8811
NPI assigned
Oct 21, 2014
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

State licenses

LicenseStateTypeSpecialty
316103WIMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 316103 WI Yes

Addresses

Primary practice location

414 N Division St
Appleton, WI 54911-4611

Mailing address

414 N Division St
Appleton, WI 54911-4611
Phone (920) 445-8811

Other providers in Appleton, WI

All providers in Appleton, WI · Licensed Practical Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.