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General NPI Number Information
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NPI Number | 1093827628
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Entity Type | Individual
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Provider Name | ERIC CLARK BINGNER CRNA
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | N1607 S MAIN ST
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City | FORT ATKINSON
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State | WI
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Zip | 53538-8736
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Country | US
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Telephone | 920-568-0436
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Fax |
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Provider Business Mailing Address
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Address Line | N1607 S. MAIN ST. FORT ATKINSON
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City | FORT ATKINSON
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State | WI
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Zip | 53538-8736
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Country | US
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Telephone | 920-650-2338
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 644033
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License Number State | WI
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