Individual
SCOTT J ROTAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
240 MAPLE ST, WOODRUFF, WI 54568-0470
(715) 892-4835
Mailing address
240 MAPLE ST, WOODRUFF, WI 54568-0470
(715) 892-4835
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
127205-030
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
051474
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43401700
—
WI
Enumeration date
06/13/2006
Last updated
04/12/2022
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