Raese, Derek Dale
Raese, Derek Dale is an sole proprietor health care provider with primary practice located at 16320 W Marietta Dr , New Berlin WI 53151-6594. He recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as his primary health care specialty. Raese, Derek Dale can be contacted via phone (414) 640-1112.Contact Information
Primary practice address
16320 W Marietta Dr
New Berlin WI 53151-6594
Phone: (414) 640-1112
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Licensed Practical Nurse | 164W00000X | 321484 | Wisconsin |
Profile Details
| NPI number | 1205309226 |
|---|---|
| LBN Legal business name | Raese, Derek Dale |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 3rd, 2019 |
| Last updated | Jan 3rd, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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