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General NPI Number Information
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NPI Number | 1548214810
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Entity Type | Individual
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Provider Name | RENE L BUENZOW DNP, PMHNP-BC, APRN
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Gender | Female
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 2901 HUNTERS TRL
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City | PORTAGE
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State | WI
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Zip | 53901-3403
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Country | US
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Telephone | 608-742-5518
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Fax | 608-268-9780
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Provider Business Mailing Address
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Address Line | 806 STONEY HILL LN
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City | COTTAGE GROVE
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State | WI
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Zip | 53527-9184
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Country | US
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Telephone | 563-422-0437
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 255039
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 10148-33
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License Number State | WI
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