Provider Demographics
NPI:1720219504
Name:WENTZEL, ALEANA NORA-MARIE (RN, BSN)
Entity Type:Individual
Prefix:
First Name:ALEANA
Middle Name:NORA-MARIE
Last Name:WENTZEL
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 DUBLIN TRL APT 44
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-1570
Mailing Address - Country:US
Mailing Address - Phone:920-740-2571
Mailing Address - Fax:
Practice Address - Street 1:1717 DUBLIN TRL APT 44
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-1570
Practice Address - Country:US
Practice Address - Phone:920-740-2571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI158261030163W00000X, 163WC0400X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WP0200XNursing Service ProvidersRegistered NursePediatrics