Community Health Network
Organization Active NPI Family Medicine Physician · Montello, WI
NPI 1578829545 · NPPES record last updated Apr 4, 2012
Key facts
- NPI
- 1578829545
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- COMMUNITY HEALTH NETWORK
- Practice address
- 215 Church St
Montello, WI 53949-9763 - Phone
- (608) 297-2626
- Fax
- (608) 297-9351
- NPI assigned
- Apr 4, 2012
- Organization subpart
- No
Authorized official
- Name
- Jayne Plagenz
- Title
- Director of Operations
- Phone
- (920) 361-5341
National Provider Directory
Locations
215 Church St
Montello, WI 53949
Phone (608) 297-2626
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
215 Church St
Montello, WI 53949-9763
Mailing address
215 Church St
Montello, WI 53949-9763
Phone (608) 297-2626
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11011000 | Medicaid | WI |
Other names
- CHN Medical Center - Montello
Other providers in Montello, WI
- Erin Kathleen Audiss
- Aurora Pharmacy Inc
- Mikayla Ann Breneman
- Mindy Kay Brown
- County of Marquette
- County of Marquette
- Lisa Dedrick
- Timothy Michael Fischer
- William T Franks
All providers in Montello, WI · Family Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2012. 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.