Individual
MRS. BRENDA MARIE VANMERSBERGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
230 N PRAIRIE DR, OCONOMOWOC, WI 53066-8617
(262) 468-8883
Mailing address
2428 N GRANDVIEW BLVD STE 102, WAUKESHA, WI 53188-6906
(262) 875-5070
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
13148
WI
363LA2200X
Adult Health Nurse Practitioner
1314833
WI
363LG0600X
Gerontology Nurse Practitioner
13148
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1314833
STATE LICENSE
WI
Enumeration date
09/20/2022
Last updated
01/06/2023
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