MRS. LACEY JO RAICHE (NPI# 1679834857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679834857 |
| Entity Type | Individual |
| Full Name | MRS. LACEY JO RAICHE |
| Credential | FNP |
| Practice Address |
3603 Schneider Avenue Menomonie WI 54751-5674 |
| Practice Telephone | 7152336400 |
| Mailing Telephone | 7152336400 |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2014-01-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | R207746-8 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
162013-30 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 1679834857 | 05 |
| Street Address |
3603 SCHNEIDER AVENUE |
| City | MENOMONIE |
| State | WI |
| Zip Code | 54751-5674 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154840569 | Ashley Friedenfels | Physical Medicine & Rehabilitation | E4486 290th Avenue, Menomonie, WI 54751 | 2017-09-18 |
| 1215307814 | David Calvin Reimann | Hearing Instrument Specialist | E4584 483rd Avenue, Menomonie, WI 54751 | 2015-09-25 |
| 1790128627 | County of Dunn | Skilled Nursing Facility | 651 Howison Circle, Menominie, WI 54751 | 2013-04-10 |
| 1043653983 | County of Dunn | Skilled Nursing Facility | 658 Howison Circle, Menomonie, WI 54751 | 2013-04-10 |
| 1447519236 | Gentle Dental Care LLC | Dentist | 1813 Wilson St., Menomonie, WI 54751 | 2012-05-14 |
| 1386960193 | Kilimanjaro LLC | Non-emergency Medical Transport (VAN) | 1222 14th Ave E, Menomonie, WI 54751 | 2010-04-19 |
| 1275709180 | Dianne Marie Bennett | Counselor | 1916 2nd St W, Menomonie, WI 54751 | 2008-05-01 |
| 1417136201 | David Gary Hackbarth | Chiropractor | 3120 Schneider Ave E, Suite #5, Menomonie, WI 54751 | 2007-10-29 |
| 1306057336 | Tonia D. Behling | Dental Hygienist | 3375 Kothlow Ave., Suite 40, Menomonie, WI 54751 | 2007-05-24 |
| 1295956282 | Danny Roger Wood | Dentist | 1603 Stout Rd, Menomonie, WI 54751 | 2007-05-01 |
| Find all providers in zip 54751 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003124819 | Kristin L. Rubenzer | Nurse Practitioner | 1125 Broadway St N, Suite 3, Menomonie, WI 54751-1578 | 2010-09-15 |
| 1124167002 | Julie Wiensch | Nurse Practitioner | 800 Wilson Ave, Menomonie, WI 54751-2734 | 2007-02-06 |
| 1366077885 | Jason Edward Heinz | Nurse Practitioner | 2919 Stout Rd, Menomonie, WI 54751-2313 | 2020-03-04 |
| 1598041311 | Angela Purpora | Nurse Practitioner | 1125 Broadway St N Ste 3, Menomonie, WI 54751-1579 | 2011-10-25 |
| 1881733764 | Dianne Robertson | Nurse Practitioner | 800 Wilson Ave, Menomonie, WI 54751-2734 | 2007-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982203857 | Tiera Manuel | Nurse Practitioner | 3956 N 28th St, Milwaukee, WI 53216-2637 | 2020-10-22 |
| 1801494778 | Tajana Jovicic | Nurse Practitioner | 3157 S 66th St, Milwaukee, WI 53219-4105 | 2020-10-13 |
| 1497352090 | Carlotta Williams | Nurse Practitioner | 1205 Juniper Ln, Oconomowoc, WI 53066-3100 | 2020-10-06 |
| 1932706611 | Rachel Sullivan | Nurse Practitioner | 304 E Northlawn Dr, Cottage Grove, WI 53527-8917 | 2020-10-05 |
| 1649877663 | Kirk O'hanison | Nurse Practitioner | 1020 Oconomowoc Pkwy Unit B, Oconomowoc, WI 53066-4616 | 2020-10-02 |
| 1780291401 | Carlie Dell | Nurse Practitioner | 1636 Industrial Pkwy N, Marinette, WI 54143-3703 | 2020-09-27 |
| 1093320459 | Tyronda T Gray | Nurse Practitioner | 5833 N 117th St, Milwaukee, WI 53225-2207 | 2020-09-12 |
| 1629683065 | Yia Lor | Nurse Practitioner | 3750 Summerset Way Apt 1, Oshkosh, WI 54901-0501 | 2020-09-11 |
| 1245844364 | Asia Ann Gomez | Nurse Practitioner | 2816 E Allison Ave, Cudahy, WI 53110-2541 | 2020-09-04 |
| 1861005837 | Clair Roser Rivera | Nurse Practitioner | 3734 W Ohio Ave, Milwaukee, WI 53215-4047 | 2020-08-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.