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NPI Code Detail

MEDICARE: MR. BRADLEY JOE BYKER CRNA

MEDICARE: MR. BRADLEY JOE BYKER CRNA
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
1367500000XCertified Registered Nurse Anesthetist138913-30WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386663706
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRADLEY JOE BYKER CRNA
Provider Business Mailing Address
First Line : 2196 84TH AVE
Second Line :
City : OSCEOLA
State : WI
Zip : 54020-4334
Country : US
Telephone Number : 715-294-4020
Fax Number :
Provider Business Practice Location Address
First Line : 130 S KNOWLES AVE
Second Line :
City : NEW RICHMOND
State : WI
Zip : 54017-1727
Country : US
Telephone Number : 715-246-3018
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 12/16/2015

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