Provider Demographics
NPI:1336613041
Name:GIVENS, BOBBI (RN)
Entity type:Individual
Prefix:
First Name:BOBBI
Middle Name:
Last Name:GIVENS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BOBBI
Other - Middle Name:
Other - Last Name:CEGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9236 W METCALF PL
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53222-2648
Mailing Address - Country:US
Mailing Address - Phone:414-610-8139
Mailing Address - Fax:
Practice Address - Street 1:1429 N ASTOR ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-2844
Practice Address - Country:US
Practice Address - Phone:414-610-8139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-15
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI178814-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse