Provider Demographics
NPI:1841627841
Name:SZNAIDER, PETRINA A (LPN)
Entity type:Individual
Prefix:MRS
First Name:PETRINA
Middle Name:A
Last Name:SZNAIDER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:PETRINA
Other - Middle Name:A
Other - Last Name:SIELAFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:500 RIVERVIEW AVE
Mailing Address - Street 2:ATTN: CLINICAL SERVICES
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-3632
Mailing Address - Country:US
Mailing Address - Phone:262-548-7666
Mailing Address - Fax:262-548-7656
Practice Address - Street 1:500 RIVERVIEW AVE
Practice Address - Street 2:ATTN: CLINICAL SERVICES
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-3632
Practice Address - Country:US
Practice Address - Phone:262-548-7666
Practice Address - Fax:262-548-7656
Is Sole Proprietor?:No
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI23261-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse