Provider Demographics
NPI:1548214810
Name:BUENZOW, RENE L (APNP-C)
Entity Type:Individual
Prefix:
First Name:RENE
Middle Name:L
Last Name:BUENZOW
Suffix:
Gender:F
Credentials:APNP-C
Other - Prefix:
Other - First Name:RENE
Other - Middle Name:L
Other - Last Name:KRIENER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APNP
Mailing Address - Street 1:675 W WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-2637
Mailing Address - Country:US
Mailing Address - Phone:608-257-9700
Mailing Address - Fax:
Practice Address - Street 1:675 WEST WASHINGTON
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-1921
Practice Address - Country:US
Practice Address - Phone:608-257-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10148-33207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN610140200Medicaid
Q50760Medicare UPIN
MN610140200Medicaid