MEDICARE: MRS. CHERYL A RENTMEESTER 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
1	363L00000X	Nurse Practitioner	2565	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2565-033	OTHER	WI	LICENSE

General Provider Information

NPI Number	:	1851375786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHERYL A RENTMEESTER APNP

Provider Business Mailing Address
First Line	:	140 B SCHOOL CREEK TRAIL
Second Line	:
City	:	LUXEMBURG
State	:	WI
Zip	:	54217
Country	:	US
Telephone Number	:	920-845-1370
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 B SCHOOL CREEK TRAIL
Second Line	:
City	:	LUXEMBURG
State	:	WI
Zip	:	54217
Country	:	US
Telephone Number	:	920-845-1370
Fax Number	:

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

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	03/19/2014

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