Provider Demographics
NPI:1013338201
Name:BIRNO, CHER KRISTINE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CHER
Middle Name:KRISTINE
Last Name:BIRNO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:CHER
Other - Middle Name:KRISTINE
Other - Last Name:BOELDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:763 IMPERIAL CT
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-4319
Mailing Address - Country:US
Mailing Address - Phone:262-388-0881
Mailing Address - Fax:
Practice Address - Street 1:763 IMPERIAL CT
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-4319
Practice Address - Country:US
Practice Address - Phone:262-388-0881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-15
Last Update Date:2013-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI306804-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse