Nathaniel J Agen, RN
Individual provider Active NPI Durable Medical Equipment & Medical Supplies · Appleton, WI
NPI 1174352694 · NPPES record last updated Aug 1, 2024
Key facts
- NPI
- 1174352694
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- License
- 147069 (WI)
- Practice address
- 1853 N Casaloma Dr
Appleton, WI 54913-7980 - Phone
- (920) 328-2001
- NPI assigned
- Aug 1, 2024
- Sex
- Male
- 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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 147069 | WI | MD | Durable Medical Equipment & Medical Supplies |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 147069 | WI | Yes |
Addresses
Primary practice location
1853 N Casaloma Dr
Appleton, WI 54913-7980
Mailing address
1853 N Casaloma Dr
Appleton, WI 54913-7980
Phone (920) 328-2001
Other providers in Appleton, WI
- Advanced Movement Studio
- Advanced Movement Studio, LLC
- Advanced Pain Management SC
- Advanced Physical Therapy & Sports Medicine SC
- Agape of Appleton, Inc.
- Richa Aggarwal
- Lisbet Aguilar
- Rebecca J Ahlborn
- Sahar Ahmad
- Abdulmohsin M Ahmadjee
All providers in Appleton, WI · Durable Medical Equipment & Medical Supplies in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2024. 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.