Provider Demographics
NPI:1750141677
Name:BENZ, RONDA J (APNP)
Entity type:Individual
Prefix:
First Name:RONDA
Middle Name:J
Last Name:BENZ
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233942 HIGHPOINT RD
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54403-8977
Mailing Address - Country:US
Mailing Address - Phone:715-581-8481
Mailing Address - Fax:
Practice Address - Street 1:2720 PLAZA DR STE 2100
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-4157
Practice Address - Country:US
Practice Address - Phone:715-847-2475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15168-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily