Individual
JEFF MATHIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
333 PINE RIDGE BLVD, ASPIRUS HOSPITAL, WAUSAU, WI 54401
(715) 847-2121
Mailing address
7212 SANDY CREEK RD, WAUSAU, WI 54401-9765
(715) 675-1123
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
77115-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44302800
—
WI
Enumeration date
01/04/2007
Last updated
07/08/2007
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