Individual
THANE J. NOTHEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
900 N 92ND ST, MILWAUKEE, WI 53226-1202
(414) 805-3000
Mailing address
900 N 92ND ST, MILWAUKEE, WI 53226-1202
(414) 805-3000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
7493
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100060147
—
WI
Enumeration date
06/30/2016
Last updated
07/25/2024
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