Individual
BRENDA JEANNE DIERSCHKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
820 E GRANT ST, APPLETON, WI 54911-3483
(920) 831-5050
(920) 738-6400
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
(920) 830-5900
(920) 738-5787
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
32439
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31741700
—
WI
Enumeration date
01/16/2007
Last updated
11/13/2015
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