Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0210X | Pediatric Nephrologist | 036.143428 | IL |
Y | 2080P0210X | Pediatric Nephrologist | 75488-20 | WI |
NPI | 1548434780 |
---|---|
Provider Name | Rachel Marie Engen |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53792-2991 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2008 |
Last Update Date | 22/09/2021 |