MR. DEREK DALE RAESE
NPI 1205309226
Licensed Practical Nurse in New Berlin, WI

Q: What is Derek Raese's NPI number?

The NPI number for Derek Raese is 1205309226. It was assigned to this individual provider in the NPPES registry on January 3, 2019.

Q: What is Derek Raese's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

Q: When was this NPI record last updated?

The NPPES record for Derek Raese was last updated on January 3, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 03, 2019

16320 W MARIETTA DR, NEW BERLIN, WI 53151(414) 640-1112 Get Directions Write a Review

NPPES record last updated: January 3, 2019. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Mr. Derek Dale Raese NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. DEREK DALE RAESE (NPI 1205309226) is an individual licensed practical nurse in New Berlin, Wisconsin, licensed in Wisconsin (321484) and active in the NPI registry since January 2019.

NPPES Registry Identity

NPI1205309226

Entity TypeIndividualMale

Primary Taxonomy164W00000X

Provider Legal NameMR. DEREK DALE RAESE

Location Address16320 W MARIETTA DRNew Berlin, WI 53151-6594

Mailing Address568 N Palm StJanesville, WI 53548-2845 · (608) 718-3260

Phone(414) 640-1112

Sole ProprietorYes

Enumeration DateJanuary 3, 2019

✔ NPI 1205309226 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers

Taxonomy Code164W00000X

License✔ Licensed in WI · 321484

Definition

A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

16320 W MARIETTA DR, New Berlin, WI 53151

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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. LORIANN MELBY RN

Registered Nurse

16320 W MARIETTA DR
NEW BERLIN, WI 53151

Waukesha County (262) 794-3719

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derek Raese's NPI number?

The NPI number for Derek Raese is 1205309226. It was assigned to this individual provider in the NPPES registry on January 3, 2019.

Where is Derek Raese located?

Derek Raese practices at 16320 W Marietta Dr, New Berlin, WI 53151. The listed phone number is (414) 640-1112.

What is Derek Raese's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Derek Raese was last updated on January 3, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.