Provider Demographics
NPI:1740965193
Name:ZASTROW, CHERYL ANN (BSN)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:ANN
Last Name:ZASTROW
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:
Other - Last Name:ZASTROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:W308S9049 COUNTY ROAD EE
Mailing Address - Street 2:
Mailing Address - City:MUKWONAGO
Mailing Address - State:WI
Mailing Address - Zip Code:53149-8305
Mailing Address - Country:US
Mailing Address - Phone:262-290-7550
Mailing Address - Fax:
Practice Address - Street 1:W315S8897 WIGWAM DR
Practice Address - Street 2:
Practice Address - City:MUKWONAGO
Practice Address - State:WI
Practice Address - Zip Code:53149-8896
Practice Address - Country:US
Practice Address - Phone:414-379-7790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI67097163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health