Provider Demographics
NPI:1790456648
Name:ENGELBRECHT, RHIANON LYN (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:RHIANON
Middle Name:LYN
Last Name:ENGELBRECHT
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 1:1300 93RD AVE
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53144-7734
Mailing Address - Country:US
Mailing Address - Phone:262-220-2243
Mailing Address - Fax:
Practice Address - Street 1:1300 93RD AVE
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53144-7734
Practice Address - Country:US
Practice Address - Phone:262-220-2243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI220756163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0200XNursing Service ProvidersRegistered NursePediatricsGroup - Single Specialty