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NPI Code Detail

MEDICARE: JOSEPH MARTIN VANDERSTEEN CRNA APNP

MEDICARE: JOSEPH MARTIN VANDERSTEEN CRNA APNP
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 Anesthetist125815-030WI

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 : 1437259363
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH MARTIN VANDERSTEEN CRNA APNP
Provider Business Mailing Address
First Line : 835 S VAN BUREN ST
Second Line :
City : GREEN BAY
State : WI
Zip : 54301-3575
Country : US
Telephone Number : 920-433-8328
Fax Number : 920-431-3082
Provider Business Practice Location Address
First Line : 835 S VAN BUREN ST
Second Line :
City : GREEN BAY
State : WI
Zip : 54301-3575
Country : US
Telephone Number : 920-433-8328
Fax Number : 920-431-3082
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 12/31/2021

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