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Individual
BRENDA J WILLKOM
Active
Individual
BRENDA J WILLKOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC, NP
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
RN008580
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000430457
—
MT
01
—
1006900
PREFERRED ONE
MT
01
—
37113
BLUE CROSS
MT
01
—
46155203
WAUSAU
MT
Enumeration date
08/29/2006
Last updated
11/14/2007
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