Treasa Hendrickson
Individual provider Active NPI Registered Nurse · Clinton, WI
NPI 1417409673 · NPPES record last updated Nov 3, 2016
Key facts
- NPI
- 1417409673
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 218361 (WI)
- Practice address
- 506 Hart Dr
Clinton, WI 53525-9104 - Phone
- (608) 931-6013
- NPI assigned
- Nov 3, 2016
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 218361 | WI | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 218361 | WI | Yes |
Addresses
Primary practice location
506 Hart Dr
Clinton, WI 53525-9104
Mailing address
506 Hart Dr
Clinton, WI 53525-9104
Phone (608) 931-6013
Other providers in Clinton, WI
- C Jean Dittmann
- Ashley Ann Furman
- Generations Care Partners Corporation Dba Caring Senior Service Milwau
- Erin Grenawalt
- Brian A Hamann
- Brooke Johansen
- Heather Lynn Kluck
- Alex Marchillo
- Tina Neisius
- Jessica Nenneman
All providers in Clinton, WI · Registered Nurse in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2016. 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.