Individual
CHRISTINE BENGTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9000 W WISCONSIN AVE, WAUWATOSA, WI 53226-4874
(414) 266-2860
(414) 266-6749
Mailing address
9000 W WISCONSIN AVE, WAUWATOSA, WI 53226-4874
(414) 266-2860
(414) 266-6749
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
225846-30
WI
363LP0200X
Pediatric Nurse Practitioner
Primary
8807-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922575349
—
WI
Enumeration date
10/24/2018
Last updated
06/05/2021
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