Czaka Bogan
Individual provider Active NPI Home Health Agency · Mount Pleasant, WI
NPI 1750136727 · NPPES record last updated Apr 22, 2024
Key facts
- NPI
- 1750136727
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 0019428 (WI)
- Practice address
- 1441 Meadowlane Ave
Mount Pleasant, WI 53406-4421 - Phone
- (262) 664-5933
- NPI assigned
- Apr 22, 2024
- 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 |
|---|---|---|---|
| 0019428 | WI | MD | Home Health Agency |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 0019428 | WI | Yes |
Addresses
Primary practice location
1441 Meadowlane Ave
Mount Pleasant, WI 53406-4421
Mailing address
1441 Meadowlane Ave
Mount Pleasant, WI 53406-4421
Phone (262) 664-5933
Other providers in Mount Pleasant, WI
- Diane L. Billmyer
- Shana Blackman
- Allison Marie Blonski
- Daniel Blonsky
- Kristine Blumm
- Carolyn Bogart
- David John Boho
- Caroline Daniela Bonilla
- Nathan Boren
- Thomas P Bormes
All providers in Mount Pleasant, WI · Home Health Agency 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 22, 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.