Healthcare Provider Details

I. General information

NPI: 1730117607
Provider Name (Legal Business Name): CHIPPEWA COUNTY DEPARTMENT OF PUBLIC HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 N BRIDGE ST RM 222
CHIPPEWA FALLS WI
54729-1845
US

IV. Provider business mailing address

711 N BRIDGE ST RM 222
CHIPPEWA FALLS WI
54729-1845
US

V. Phone/Fax

Practice location:
  • Phone: 715-726-7905
  • Fax: 715-726-7910
Mailing address:
  • Phone: 715-726-7905
  • Fax: 715-726-7910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateWI

VIII. Authorized Official

Name: JEAN C DURCH
Title or Position: PUBLIC HEALTH OFFICER/DIRECTOR
Credential: RN, MPH
Phone: 715-726-7906