Individual
BREANA M VANDOORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
855 N WESTHAVEN DR, OSHKOSH, WI 54904-7668
(920) 303-8700
Mailing address
525 FOX FIRE DR, OSHKOSH, WI 54904-6585
(920) 410-3882
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
157210-030
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
106908
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100052597
—
WI
Enumeration date
11/17/2015
Last updated
07/25/2023
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