Provider Demographics
NPI:1609906213
Name:REXFORD, KRISTEN SVE (OTR)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:SVE
Last Name:REXFORD
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 PINE RIDGE BOULEVARD
Mailing Address - Street 2:ASPIRUS WAUSAU HOSPITAL- REHABILITATION
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401
Mailing Address - Country:US
Mailing Address - Phone:920-339-0515
Mailing Address - Fax:
Practice Address - Street 1:333 PINE RIDGE BOULEVARD
Practice Address - Street 2:ASPIRUS WAUSAU HOSPITAL- REHABILITATION
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401
Practice Address - Country:US
Practice Address - Phone:715-847-2833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2520225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40784100Medicaid