Provider Demographics
NPI:1710749957
Name:BARTKUS, ANGELA M (RN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:BARTKUS
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 1:741 CRESTHILL CT
Mailing Address - Street 2:
Mailing Address - City:CEDARBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53012-9604
Mailing Address - Country:US
Mailing Address - Phone:262-622-3950
Mailing Address - Fax:
Practice Address - Street 1:741 CRESTHILL CT
Practice Address - Street 2:
Practice Address - City:CEDARBURG
Practice Address - State:WI
Practice Address - Zip Code:53012-9604
Practice Address - Country:US
Practice Address - Phone:262-622-3950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI172698-30163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator