Healthcare Provider Details

I. General information

NPI: 1326396342
Provider Name (Legal Business Name): KRISTEN H. BACHMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2012
Last Update Date: 08/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5946 N BAY RIDGE AVE
MILWAUKEE WI
53217-4603
US

IV. Provider business mailing address

5946 N BAY RIDGE AVE
MILWAUKEE WI
53217-4603
US

V. Phone/Fax

Practice location:
  • Phone: 414-964-7469
  • Fax:
Mailing address:
  • Phone: 414-964-7469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number69831030
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: