Provider Demographics
NPI:1194582924
Name:NAGEL NEIGHBORHOOD HEALTH LLC
Entity type:Organization
Organization Name:NAGEL NEIGHBORHOOD HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINNEA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGEL
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:920-631-1310
Mailing Address - Street 1:612 MARY KNOLL LN
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53098-1216
Mailing Address - Country:US
Mailing Address - Phone:920-631-1310
Mailing Address - Fax:920-335-3570
Practice Address - Street 1:612 MARY KNOLL LN
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:WI
Practice Address - Zip Code:53098-1216
Practice Address - Country:US
Practice Address - Phone:920-631-1310
Practice Address - Fax:920-335-3570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-28
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty