Individual
DANE JAE HARDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3400 MINISTRY PKWY, WESTON, WI 54476-5220
(715) 393-2652
Mailing address
5708 CONNIE LN, WESTON, WI 54476-4254
(715) 298-9111
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
73953
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
394
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43285000
—
WI
Enumeration date
06/01/2006
Last updated
11/17/2022
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