Provider Demographics
NPI:1154619575
Name:BATTERMAN, GINA ROSE (RN)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:ROSE
Last Name:BATTERMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:ROSE
Other - Last Name:PRIMAVERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:909 BURNING WOOD WAY
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-1015
Mailing Address - Country:US
Mailing Address - Phone:608-285-5693
Mailing Address - Fax:608-263-6350
Practice Address - Street 1:909 BURNING WOOD WAY
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-1015
Practice Address - Country:US
Practice Address - Phone:608-285-5693
Practice Address - Fax:608-263-6350
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI174007-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse