Healthcare Provider Details

I. General information

NPI: 1992972913
Provider Name (Legal Business Name): CINDY KAY WHEELER RN/RCS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2008
Last Update Date: 05/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11915 TORMEY RD
STITZER WI
53825-9752
US

IV. Provider business mailing address

11915 TORMEY RD
STITZER WI
53825-9752
US

V. Phone/Fax

Practice location:
  • Phone: 608-943-8416
  • Fax:
Mailing address:
  • Phone: 608-943-8416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number91471
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: