| Vivian L Dehahn, APNP | |
|
33300 Cayuga Way, East Troy, WI 53120-9633 | |
| (262) 210-0563 | |
| Not Available |
| Full Name | Vivian L Dehahn |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Location | 33300 Cayuga Way, East Troy, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538154539 | NPI | - | NPPES |
| 43893400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 88058-030 (Wisconsin) | Secondary |
| 363L00000X | Nurse Practitioner | 1451-033 (Wisconsin) | Primary |
| Entity Name | Aurora Medical Group, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
| Mailing Address | Practice Location Address |
|---|---|
| Vivian L Dehahn, APNP 33300 Cayuga Way, East Troy, WI 53120-9633 Ph: (262) 210-0563 | Vivian L Dehahn, APNP 33300 Cayuga Way, East Troy, WI 53120-9633 Ph: (262) 210-0563 |
Hana O Upright, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2483 Corporate Cir, East Troy, WI 53120 Phone: 262-642-2000 Fax: 262-642-2143 | |
Mrs. Kelly L Brendel, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: W571 County Road L, East Troy, WI 53120 Phone: 815-222-1641 | |
Richard Datka, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: N8134 Bell School Rd, East Troy, WI 53120 Phone: 615-999-5679 |