Provider Demographics
NPI:1902156326
Name:RINDFLEISCH, ALLEN (APN)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:
Last Name:RINDFLEISCH
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 E PUETZ RD
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-3254
Mailing Address - Country:US
Mailing Address - Phone:414-877-4570
Mailing Address - Fax:414-304-8065
Practice Address - Street 1:331 E PUETZ RD
Practice Address - Street 2:
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154-3254
Practice Address - Country:US
Practice Address - Phone:414-877-4570
Practice Address - Fax:414-296-4065
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9598-33363L00000X
WI9598363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100094837Medicaid
1902156326OtherNPI