Jennifer Depagter, CRNA | |
3200 Pleasant Valley Rd, West Bend, WI 53095-9274 | |
(262) 836-7300 | |
(262) 836-7301 |
Full Name | Jennifer Depagter |
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Gender | Female |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 3200 Pleasant Valley Rd, West Bend, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1669012845 | NPI | - | NPPES |
1669012845 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 2417 (Minnesota) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 11577 (Wisconsin) | Primary |
Entity Name | Park Nicollet Methodist Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083622047 PECOS PAC ID: 7315840063 Enrollment ID: O20040129000853 |
Mailing Address | Practice Location Address |
---|---|
Jennifer Depagter, CRNA 3200 Pleasant Valley Rd, West Bend, WI 53095-9274 Ph: (262) 836-7300 | Jennifer Depagter, CRNA 3200 Pleasant Valley Rd, West Bend, WI 53095-9274 Ph: (262) 836-7300 |
Mr. Benjamin T Skubal, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3200 Pleasant Valley Rd, West Bend, WI 53095 Phone: 262-836-7300 Fax: 262-836-7301 | |
Lynne M Krebs, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 661 S Silverbrook Dr, West Bend, WI 53095 Phone: 262-335-0533 | |
Toni M Reinhart, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3200 Pleasant Valley Rd, West Bend, WI 53095 Phone: 262-836-5533 | |
Thomas D Saugen, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 3200 Pleasant Valley Rd, West Bend, WI 53095 Phone: 262-334-5533 | |
Bradley R Brooke, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3200 Pleasant Valley Rd, West Bend, WI 53095 Phone: 262-334-5533 | |
Allen H Schut, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 3200 Pleasant Valley Rd, West Bend, WI 53095 Phone: 262-334-5533 |