Provider Demographics
NPI:1366420283
Name:VANHANDEL, GWEN FRANCINE (RN)
Entity type:Individual
Prefix:MRS
First Name:GWEN
Middle Name:FRANCINE
Last Name:VANHANDEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:GWEN
Other - Middle Name:FRANCINE
Other - Last Name:GILBERTSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:910 WAUGOO AVE
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54901
Mailing Address - Country:US
Mailing Address - Phone:920-232-9646
Mailing Address - Fax:
Practice Address - Street 1:542 CAMELOT CT
Practice Address - Street 2:APT #1
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54901
Practice Address - Country:US
Practice Address - Phone:920-232-8118
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38254500Medicare ID - Type Unspecified