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Individual

SAMANTHA BRANDT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
REGISTERED NURSE

Contact information

Practice address
10825 47TH AVE, PLEASANT PRAIRIE, WI 53158-3526
(630) 220-9871
Mailing address
10825 47TH AVE, PLEASANT PRAIRIE, WI 53158-3526

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.409847
IL
163W00000X
Registered Nurse
Primary
23838730
WI

Other

Enumeration date
11/03/2017
Last updated
11/03/2017
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