1316023542 NPI number — MRS. RACHEL ANN MONFILS BSW CSW

Table of content: MRS. RACHEL ANN MONFILS BSW CSW (NPI 1316023542)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316023542 NPI number — MRS. RACHEL ANN MONFILS BSW CSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MONFILS
Provider First Name:
RACHEL
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
BSW CSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KRAEMER
Provider Other First Name:
RACHEL
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1316023542
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 22308
Provider Second Line Business Mailing Address:
300 CROOKS STREET
Provider Business Mailing Address City Name:
GREEN BAY
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54305-2308
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
920-436-6800
Provider Business Mailing Address Fax Number:
920-432-5966

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 CROOKS STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREEN BAY
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
920-436-6800
Provider Business Practice Location Address Fax Number:
920-432-5966
Provider Enumeration Date:
10/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X , with the licence number:  9221120 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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