Provider Demographics
NPI:1417923921
Name:SVINGEN, PAUL (CRNA)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:SVINGEN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 SANDY CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOREB
Mailing Address - State:WI
Mailing Address - Zip Code:53572-2344
Mailing Address - Country:US
Mailing Address - Phone:608-437-4662
Mailing Address - Fax:
Practice Address - Street 1:112 SANDY CT
Practice Address - Street 2:
Practice Address - City:MOUNT HOREB
Practice Address - State:WI
Practice Address - Zip Code:53572-2344
Practice Address - Country:US
Practice Address - Phone:608-437-4662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI95910367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered