Graduated: 2020
NPI: 1649777293
Practice Locations (2)
PRAIRIE RIDGE HEALTH INC
1515 PARK AVE
COLUMBUS, WI 539251618
9206232200
NURSE ANESTHESIA PROFESSIONAL SERVICES LLC
1077 W MASON ST
GREEN BAY, WI 543031858
9204971810
Source: CMS National Downloadable File, September 2026.