Individual
BREANN PAIGE ADAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1970 S 84TH ST, WEST ALLIS, WI 53227-1702
(262) 617-3154
Mailing address
1970 S 84TH ST, WEST ALLIS, WI 53227-1702
(262) 617-3154
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
183686-30
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163W00000X
—
WI
Enumeration date
05/30/2012
Last updated
01/27/2015
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