Provider Demographics
NPI:1710395215
Name:BATCHULUUN, SARAN (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:SARAN
Middle Name:
Last Name:BATCHULUUN
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4250 W LAKE AVE APT C202
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-7419
Mailing Address - Country:US
Mailing Address - Phone:920-712-5317
Mailing Address - Fax:
Practice Address - Street 1:2364 JACKSON ST
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:WI
Practice Address - Zip Code:53589-5404
Practice Address - Country:US
Practice Address - Phone:920-712-5317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI171297-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse