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NPI Code Detail

MEDICARE: GRETCHEN SAUDER RN

MEDICARE: GRETCHEN SAUDER 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 Nurse25589230WI

General Provider Information

NPI Number : 1245813856
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRETCHEN SAUDER RN
Provider Business Mailing Address
First Line : 1511 N WATER ST APT 212
Second Line :
City : MILWAUKEE
State : WI
Zip : 53202-2332
Country : US
Telephone Number : 309-339-8650
Fax Number :
Provider Business Practice Location Address
First Line : 1511 N WATER ST APT 212
Second Line :
City : MILWAUKEE
State : WI
Zip : 53202-2332
Country : US
Telephone Number : 309-339-8650
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2021
Last Update Date : 05/02/2021

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