Jane Marie Hertel, OTR

Individual provider Active NPI Pediatric Occupational Therapist · Denmark, WI

NPI 1568613461 · NPPES record last updated Oct 9, 2008

Key facts

NPI
1568613461
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Occupational Therapist 225XP0200X
License
1568-026 (WI)
Practice address
5798 S Hwy T
Denmark, WI 54208
Phone
(920) 863-6214
NPI assigned
Oct 9, 2008
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
1568-026WIMDPediatric Occupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 1568-026 WI Yes

Addresses

Primary practice location

5798 S Hwy T
Denmark, WI 54208

Mailing address

5798 S Hwy T
Denmark, WI 54208-9463
Phone (920) 863-6214

Other identifiers

IdentifierTypeStateIssuer
40529100MedicaidWI
1568-026OtherWISTATE OF WISCONSIN DEPARTMENT OF REGULATION AND LICENSING

Other providers in Denmark, WI

All providers in Denmark, WI · Pediatric Occupational Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.