Healthcare Provider Details

I. General information

NPI: 1366420283
Provider Name (Legal Business Name): GWEN FRANCINE VANHANDEL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: GWEN FRANCINE GILBERTSON RN

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

542 CAMELOT CT APT #1
OSHKOSH WI
54901
US

IV. Provider business mailing address

910 WAUGOO AVE
OSHKOSH WI
54901
US

V. Phone/Fax

Practice location:
  • Phone: 920-232-8118
  • Fax:
Mailing address:
  • Phone: 920-232-9646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: