Jeffery P Antonissen in Green Bay - Nurse Anesthetist, Certified Registered
Jeffery P Antonissen - NPI 1760494512
Jeffery P Antonissen is a Nurse Anesthetist, Certified Registered in Green Bay, Wisconsin. Jeffery P Antonissen practices all healthcare services and medical treatments related to Nurse Anesthetist, Certified Registered. The NPI Number for Jeffery P Antonissen is 1760494512. The last update date is 2022-05-20.
Jeffery P Antonissen's current location address is 2845 Greenbrier Rd, Green Bay, Wisconsin. You can contact this provider via phone number 9202883388 and fax number 9202883370. The mailing address for Jeffery P Antonissen is 2845 Greenbrier Rd, Green Bay, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jeffery P Antonissen |
|---|---|
| Address | 2845 Greenbrier Rd, Green Bay, Wisconsin |
| Phone Number | 9202883388 |
| Fax Number | 9202883370 |
| Sole Proprietor | N |
| Credentials | CRNA |
NPI Number Detail
| NPI Number | 1760494512 |
|---|---|
| Provider Enumeration Date | 2006-08-12 |
| Last Updated Date | 2022-05-20 |
Provider Mailing Address Detail
| Address | 2845 Greenbrier Rd |
|---|---|
| City | Green Bay |
| State | Wisconsin (WI) |
| Post Code | 543088900 |
| Phone Number | 9202883388 |
| Fax Number | 9202883370 |
Provider's Primary Taxonomy Detail
| Speciality | Nurse Anesthetist, Certified Registered |
|---|---|
| Taxonomy | 367500000X |
| Licence No | 113583 |
|
Definition: (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| P00033987 | WI | RAILROAD | |
| 104521249 | MI | -- | |
| 104521230 | MI | -- | |
| 43399100 | WI | -- |
Post Comment/ Review Below
What is the Jeffery P Antonissen's 1760494512?
The Jeffery P Antonissen's NPI (National Provider Identifier) Number is 1760494512. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Jeffery P Antonissen's physical address?
The Jeffery P Antonissen is physically located at 2845 Greenbrier Rd, in the city of Green Bay, WI, with the postal code 543088900.
What is Jeffery P Antonissen's specialized field of practice, and what is the corresponding taxonomy classification code?
The Jeffery P Antonissen's area of specialization is Nurse Anesthetist, Certified Registered, and the corresponding taxonomy code that categorizes this field of practice is 367500000X.
When did the Jeffery P Antonissen receive its 1760494512?
The Jeffery P Antonissen was issued its 1760494512 on 2006-08-12, which is the date when the organization was assigned this unique identifier.
When was the Jeffery P Antonissen's information last updated?
The Jeffery P Antonissen's information was last updated on 2022-05-20.