MEDICARE: DR. CHRISTINA A BAJOREK PHD, 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
1	163WP0808X	Psychiatric/Mental Health Registered Nurse	166700-30	WI

General Provider Information

NPI Number	:	1588354260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINA A BAJOREK PHD, RN

Provider Business Mailing Address
First Line	:	3528 S 87TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53228-1514
Country	:	US
Telephone Number	:	414-975-6660
Fax Number	:

Provider Business Practice Location Address
First Line	:	3528 S 87TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53228-1514
Country	:	US
Telephone Number	:	414-975-6660
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2023
Last Update Date	:	05/08/2023

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