Individual
MELISSA D BRENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
945 N 12TH ST, MILWAUKEE, WI 53233-1305
(414) 219-2000
Mailing address
945 N 12TH ST, MILWAUKEE, WI 53233-1305
(414) 219-7021
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4142
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100072135
—
WI
Enumeration date
08/11/2017
Last updated
11/06/2023
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