Individual
MRS. CHERYL ANN BREITLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
W264N4974 BAYBERRY DR, PEWAUKEE, WI 53072-1114
(262) 224-4407
Mailing address
W264N4974 BAYBERRY DR, PEWAUKEE, WI 53072-1114
(262) 224-4407
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
82550
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AHT462302AHC
ANTHEM BLUECROSS BLUESHIELD
WI
Enumeration date
01/30/2019
Last updated
01/30/2019
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