Individual
JENNIFER DEPAGTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3200 PLEASANT VALLEY RD, WEST BEND, WI 53095-9274
(262) 836-7300
(262) 836-7301
Mailing address
3200 PLEASANT VALLEY RD, WEST BEND, WI 53095-9274
(262) 836-7300
(262) 836-7301
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
11577
WI
367500000X
Certified Registered Nurse Anesthetist
2417
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669012845
—
WI
Enumeration date
01/15/2020
Last updated
05/09/2024
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