Healthcare Provider Details

I. General information

NPI: 1447449319
Provider Name (Legal Business Name): BARBARA J KUECHLER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2007
Last Update Date: 10/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2422 NORTH GRANDVIEW BLVD
WAUKESHA WI
53188
US

IV. Provider business mailing address

2422 NORTH GRANDVIEW BLVD
WAUKESHA WI
53188
US

V. Phone/Fax

Practice location:
  • Phone: 262-549-6600
  • Fax: 262-549-6698
Mailing address:
  • Phone: 262-549-6600
  • Fax: 262-549-6698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: