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Individual

MRS. BRIGITTE ELISE WITTENBERGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
318 BROOKSIDE DR UNIT 6, MAYVILLE, WI 53050-2847
(920) 214-3423
Mailing address
318 BROOKSIDE DR UNIT 6, MAYVILLE, WI 53050-2847
(920) 214-3423

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
309698-31
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
309698-31
NURSING LICENSE
WI
Enumeration date
07/08/2012
Last updated
07/08/2012
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