Individual
BRENDAN J NASHOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
130 CORPORATE DR, BEAVER DAM, WI 53916-3116
(920) 877-3102
(920) 885-8790
Mailing address
130 CORPORATE DR, BEAVER DAM, WI 53916-3116
(920) 877-3102
(920) 885-8790
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
861-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760433189
—
WI
Enumeration date
05/12/2006
Last updated
02/11/2021
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