Healthcare Provider Details

I. General information

NPI: 1245385848
Provider Name (Legal Business Name): WILLIAM GURSKE CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 04/12/2024
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11101 N SHERMAN RD
EDGERTON WI
53534-9002
US

IV. Provider business mailing address

709 BLUE RIDGE PKWY
MADISON WI
53705-1145
US

V. Phone/Fax

Practice location:
  • Phone: 608-884-3441
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number052845
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: