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General NPI Number Information
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NPI Number | 1346054863
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Entity Type | Individual
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Provider Name | CHARLIE JAMES ASCHENBACH RN
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Gender | Male
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Dates
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Enumeration Date | 02/05/2025
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | N4673 MAYFLOWER RD
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City | BLACK CREEK
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State | WI
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Zip | 54106-8025
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Country | US
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Telephone | 920-757-5716
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Fax |
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Provider Business Mailing Address
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Address Line | 1315 CRYSTAL COVE TRL UNIT 3
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City | GREEN BAY
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State | WI
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Zip | 54311-4298
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Country | US
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Telephone | 920-316-0813
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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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 1108435-30
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License Number State | WI
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