Provider Demographics
NPI:1013007251
Name:WACHUTA, HELEN MAE (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:MAE
Last Name:WACHUTA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MISS
Other - First Name:HELEN
Other - Middle Name:MAE
Other - Last Name:MCGRATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6752 COUNTY HIGHWAY J
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:WI
Mailing Address - Zip Code:54656-3700
Mailing Address - Country:US
Mailing Address - Phone:608-366-1188
Mailing Address - Fax:
Practice Address - Street 1:855 MANKATO AVE
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-4868
Practice Address - Country:US
Practice Address - Phone:507-457-4484
Practice Address - Fax:507-457-4107
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR156181-0367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered