Depagter, Jennifer

Depagter, Jennifer is an individual health care provider with primary practice located at 3200 Pleasant Valley Rd , West Bend WI 53095-9274. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Depagter, Jennifer can be contacted via phone (262) 836-7300.

Contact Information

Primary practice address
3200 Pleasant Valley Rd West Bend WI 53095-9274
Phone: (262) 836-7300
Fax: (262) 836-7301
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 2417 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 11577 Wisconsin

Profile Details

NPI number 1669012845
LBN Legal business name Depagter, Jennifer
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 15th, 2020
Last updated May 9th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669012845 NPPES
Wisconsin MEDICAID 1669012845

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