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NPI Code Detail

MEDICARE: ASHLEIGH MAYENSCHEIN RN

MEDICARE: ASHLEIGH MAYENSCHEIN RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse172230-030WI

General Provider Information

NPI Number : 1013289008
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEIGH MAYENSCHEIN RN
Provider Business Mailing Address
First Line : 1829 JEFFERSON DR
Second Line :
City : STURGEON BAY
State : WI
Zip : 54235-3247
Country : US
Telephone Number : 920-495-1135
Fax Number :
Provider Business Practice Location Address
First Line : 1829 JEFFERSON DR
Second Line :
City : STURGEON BAY
State : WI
Zip : 54235-3247
Country : US
Telephone Number : 920-495-1135
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2012
Last Update Date : 02/06/2012

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Directions to “ ASHLEIGH MAYENSCHEIN RN” Practice Location

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