Provider Demographics
NPI:1396287447
Name:CHA, DEE (CRNA, APNP)
Entity type:Individual
Prefix:
First Name:DEE
Middle Name:
Last Name:CHA
Suffix:
Gender:F
Credentials:CRNA, APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 MILITARY RD
Mailing Address - Street 2:
Mailing Address - City:ROTHSCHILD
Mailing Address - State:WI
Mailing Address - Zip Code:54474-1858
Mailing Address - Country:US
Mailing Address - Phone:414-852-1717
Mailing Address - Fax:
Practice Address - Street 1:105 MILITARY RD
Practice Address - Street 2:
Practice Address - City:ROTHSCHILD
Practice Address - State:WI
Practice Address - Zip Code:54474-1858
Practice Address - Country:US
Practice Address - Phone:414-852-1717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-07
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI114321367500000X
WI178132-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered