Provider Demographics
NPI:1194998195
Name:NEUSER, LINDA M (CRNA)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:NEUSER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:M
Other - Last Name:MCCABE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 23400
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54305-3400
Mailing Address - Country:US
Mailing Address - Phone:920-445-7217
Mailing Address - Fax:920-445-7229
Practice Address - Street 1:744 S WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-3505
Practice Address - Country:US
Practice Address - Phone:920-433-5582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI287207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43277800Medicaid
WIS05375Medicare UPIN