Provider Demographics
NPI:1124266259
Name:DYNEK, CORI LYN (RN,BSN)
Entity type:Individual
Prefix:
First Name:CORI
Middle Name:LYN
Last Name:DYNEK
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53027-2729
Mailing Address - Country:US
Mailing Address - Phone:414-699-9845
Mailing Address - Fax:
Practice Address - Street 1:539 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:WI
Practice Address - Zip Code:53027-2729
Practice Address - Country:US
Practice Address - Phone:414-699-9845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI147857-30163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health