Provider Demographics
NPI:1598994162
Name:MATHEY, ROSEMARIE ANNE (RN)
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:ANNE
Last Name:MATHEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54303-6429
Mailing Address - Country:US
Mailing Address - Phone:920-494-1906
Mailing Address - Fax:
Practice Address - Street 1:1830 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54303-6429
Practice Address - Country:US
Practice Address - Phone:920-494-1906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-04
Last Update Date:2009-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI125297-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse