Individual
REBECCA B MAUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6308 8TH AVE, KENOSHA, WI 53143
(262) 656-2011
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
165541
WI
163W00000X
Registered Nurse
RN160242
AZ
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA0645
AZ
Other
Enumeration date
03/17/2009
Last updated
09/06/2018
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