# BRENDA J WILLKOM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1750490561
- **Gender:** F
- **Credential:** RNC, NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LX0001X | Obstetrics & Gynecology Nurse Practitioner | RN008580 | MT | Yes |

## Other

- **Enumeration date:** 08/29/2006
- **Last updated:** 11/14/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0000430457 | — | MT |
| 01 | — | 1006900 | PREFERRED ONE | MT |
| 01 | — | 37113 | BLUE CROSS | MT |
| 01 | — | 46155203 | WAUSAU | MT |