Jennifer Verhagen, RN

Individual provider Active NPI Registered Nurse · Little Chute, WI

NPI 1932472297 · NPPES record last updated Feb 17, 2012

Key facts

NPI
1932472297
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
185378-30 (WI)
Practice address
1512 Violet LN
Little Chute, WI 54140-2445
Phone
(920) 470-5043
NPI assigned
Feb 17, 2012
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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
185378-30WIMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 185378-30 WI Yes

Addresses

Primary practice location

1512 Violet LN
Little Chute, WI 54140-2445

Mailing address

1512 Violet LN
Little Chute, WI 54140-2445
Phone (920) 470-5043

Other providers in Little Chute, WI

All providers in Little Chute, WI · Registered Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.