Individual
ESTEBAN HENRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1032 E SUMNER ST, HARTFORD, WI 53027-1608
(262) 673-2300
(262) 670-7620
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(803) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
15858
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100292894
—
WI
Enumeration date
08/26/2022
Last updated
11/05/2024
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