Individual
DENISE R GATIEN BRUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
723 PARK RIDGE LN, NORTH FOND DU LAC, WI 54937-1385
(920) 926-8600
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8340
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
103096
WI
363LF0000X
Family Nurse Practitioner
Primary
103096
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1002654
TOUCHPOINT
WV
01
—
12658
DEAN
WI
01
—
39080723684
UNITY
WI
05
—
43833400
—
WI
01
—
500000913
RAILROAD MEDICARE
WI
01
—
WI01N8
JOHN DEERE
WI
Enumeration date
11/03/2005
Last updated
02/08/2021
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