Healthcare Provider Details

I. General information

NPI: 1235135401
Provider Name (Legal Business Name): CHRISTINE M HEIN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 03/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2655 COUNTY HIGHWAY I
CHIPPEWA FALLS WI
54729-1423
US

IV. Provider business mailing address

1000 N OAK AVE
MARSHFIELD WI
54449-5703
US

V. Phone/Fax

Practice location:
  • Phone: 715-726-4200
  • Fax:
Mailing address:
  • Phone: 715-387-5511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1240
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: