Provider Demographics
NPI:1538866363
Name:RIMMER, CHASADIE (AFH PROVIDER)
Entity type:Individual
Prefix:
First Name:CHASADIE
Middle Name:
Last Name:RIMMER
Suffix:
Gender:F
Credentials:AFH PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7408 W HOPE AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-1014
Mailing Address - Country:US
Mailing Address - Phone:414-202-7950
Mailing Address - Fax:414-488-2478
Practice Address - Street 1:7408 W HOPE AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-1014
Practice Address - Country:US
Practice Address - Phone:414-202-7950
Practice Address - Fax:414-488-2478
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI0018045376G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator