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General NPI Number Information
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NPI Number | 1275518276
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Entity Type | Individual
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Provider Name | THERESA A. ASCHENBRENER C.R.N.A.
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Gender | Female
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Dates
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Enumeration Date | 12/13/2005
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Last Update Date | 02/09/2009
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Provider Practice Location Address
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Address Line | 6308 8TH AVE
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City | KENOSHA
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State | WI
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Zip | 53143-5031
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Country | US
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Telephone | 262-656-2011
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Fax |
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Provider Business Mailing Address
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Address Line | 225 S EXECUTIVE DR
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City | BROOKFIELD
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State | WI
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Zip | 53005-4266
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Country | US
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Telephone | 262-787-4026
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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 | 100352
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License Number State | WI
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