Benjamin Layne Eithun, CRNP | |
E401 23rd St, Brodhead, WI 53520-2203 | |
(262) 701-7257 | |
Not Available |
Full Name | Benjamin Layne Eithun |
---|---|
Gender | Male |
Speciality | Nurse Practitioner - Pediatrics |
Location | E401 23rd St, Brodhead, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1902132376 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | 5064 (Wisconsin) | Secondary |
363LP0200X | Nurse Practitioner - Pediatrics | RN1000896 (Massachusetts) | Primary |
Entity Name | University Of Wisconsin Medical Foundation Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1598784555 PECOS PAC ID: 6608785464 Enrollment ID: O20031111000435 |
Mailing Address | Practice Location Address |
---|---|
Benjamin Layne Eithun, CRNP 937 Merri Hill Dr, Oregon, WI 53575-1001 Ph: (608) 212-9866 | Benjamin Layne Eithun, CRNP E401 23rd St, Brodhead, WI 53520-2203 Ph: (262) 701-7257 |
Darcey Jo Bedward, FNP APNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 8325 S Avon Store Rd, Brodhead, WI 53520 Phone: 608-449-8207 | |
Carmen Huenerberg, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2310 1st Center Ave, Brodhead, WI 53520 Phone: 608-897-8664 | |
Jacqueline Leigh Conway, APNP-FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1904 1st Center Ave, Brodhead, WI 53520 Phone: 608-897-2191 |