| Jennifer Depagter, CRNA | |
|
3200 Pleasant Valley Rd, West Bend, WI 53095-9274 | |
| (262) 836-7300 | |
| (262) 836-7301 |
| Full Name | Jennifer Depagter |
|---|---|
| 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 | The Medical College Of Wisconsin Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699720086 PECOS PAC ID: 2668384371 Enrollment ID: O20031120000259 |
| Entity Name | Froedtert &the Medical College Of Wisconsin Community Physicians Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568787448 PECOS PAC ID: 3678760063 Enrollment ID: O20101210000699 |
| Entity Name | Orthopaedic Hospital Of Wisconsin, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669584983 PECOS PAC ID: 4981741709 Enrollment ID: O20160106001182 |
| 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. Matthew R Mueller, CRNA 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 | |
Kari L Chakrabarti, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 3200 Pleasant Valley Rd, West Bend, WI 53095 Phone: 262-836-7300 Fax: 262-836-7301 | |
Kristen N Burg, APNP, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 3200 Pleasant Valley Rd, West Bend, WI 53095 Phone: 262-836-7300 Fax: 262-836-7301 | |
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 | |
Kerrie Lynn Goza, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 3200 Pleasant Valley Rd, West Bend, WI 53095 Phone: 262-836-7300 Fax: 262-836-7301 | |
Calli Lemke, Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare 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 |