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NPI Code Detail

MEDICARE: CHRISTINA CODNER MSW, CAPSW

MEDICARE: CHRISTINA CODNER MSW, CAPSW
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
1104100000XSocial Worker128054-121WI

General Provider Information

NPI Number : 1255941951
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA CODNER MSW, CAPSW
Provider Business Mailing Address
First Line : 27 SUNBEAM CT
Second Line :
City : APPLETON
State : WI
Zip : 54915-4113
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1710 LAWRENCE DR STE 200
Second Line :
City : DE PERE
State : WI
Zip : 54115-9195
Country : US
Telephone Number : 920-570-6339
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2020
Last Update Date : 08/06/2020

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