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Individual

BRENDA JO MCCLELLAN-TILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP, MSN

Contact information

Practice address
1355 8TH ST S, WISCONSIN RAPIDS, WI 54494-5265
(715) 423-9610
(715) 423-7753
Mailing address
302 N JACKSON ST, MILWAUKEE, WI 53202-5904
(715) 423-9610
(715) 423-7753

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
75722-030
WI
363LW0102X
Women's Health Nurse Practitioner
Primary
789-33
WI

Other

Enumeration date
04/03/2007
Last updated
08/19/2013
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