Provider Demographics
NPI:1346054863
Name:ASCHENBACH, CHARLIE JAMES (RN)
Entity type:Individual
Prefix:MR
First Name:CHARLIE
Middle Name:JAMES
Last Name:ASCHENBACH
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 CRYSTAL COVE TRL UNIT 3
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-4298
Mailing Address - Country:US
Mailing Address - Phone:920-316-0813
Mailing Address - Fax:
Practice Address - Street 1:N4673 MAYFLOWER RD
Practice Address - Street 2:
Practice Address - City:BLACK CREEK
Practice Address - State:WI
Practice Address - Zip Code:54106-8025
Practice Address - Country:US
Practice Address - Phone:920-757-5716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1108435-30163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health