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Individual

JOLINE BROTZMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, RN, PMHCNS-BC

Contact information

Practice address
459 E 1ST ST, FOND DU LAC, WI 54935-4505
(920) 922-3324
(920) 929-3129
Mailing address
298 E 1ST ST, FOND DU LAC, WI 54935-4357
(920) 315-3922
(920) 214-1076

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5048-33
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5048-33
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100026161
WI
05
100084008
WI
Enumeration date
09/17/2012
Last updated
05/07/2024
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