Healthcare Provider Details

I. General information

NPI: 1255332250
Provider Name (Legal Business Name): CHRISTOPHER G BJORKLUND CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 11/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 N DEWEY AVE
REEDSBURG WI
53959-1049
US

IV. Provider business mailing address

2000 N DEWEY AVE
REEDSBURG WI
53959-1049
US

V. Phone/Fax

Practice location:
  • Phone: 608-524-6487
  • Fax: 608-524-0842
Mailing address:
  • Phone: 608-524-6487
  • Fax: 608-524-0842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number124342
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: