Individual
KRISTEN A BRAZZALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
2920 SUPERIOR AVE, SHEBOYGAN, WI 53081-1944
(920) 496-4700
Mailing address
2920 SUPERIOR AVE, SHEBOYGAN, WI 53081-1944
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2469-33
WI
363LA2200X
Adult Health Nurse Practitioner
246933
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21280500
—
WI
05
—
41194400
—
WI
Enumeration date
07/03/2006
Last updated
10/01/2014
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