Individual ProviderBecky DienbergNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2801 W Kk River Pkwy, Suite 930, Milwaukee, WI 53215-3669(414) 384-5111(414) 352-3100PECOS EnrollmentBased on the most recent information from CMS, provider Becky Dienberg is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1659757789Provider TypeIndividualFull NameDienberg, BeckyCredentialNPGenderFemaleSole ProprietorNoEnumeration Date7/30/2015Last Updated8/14/2024Contact InformationPractice LocationPractice Address2801 W Kk River Pkwy, Suite 930, Milwaukee, WI 53215-3669Phone(414) 384-5111FaxUnlisted FaxMailing LocationMailing Address3003 W Good Hope Rd, Milwaukee, WI 53209-2042Phone(414) 352-3100FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense6502WisconsinProvider IdentifiersIDDescriptionIssuerID100048238DescriptionMedicaidIssuerUnlistedWisconsin