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Individual

CHRISTINE ANN BRZAKALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP

Contact information

Practice address
1475 W GRAND AVE, PORT WASHINGTON, WI 53074-2074
(262) 268-5100
Mailing address
1475 W GRAND AVE, PORT WASHINGTON, WI 53074-2074
(262) 268-5100

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4506-033
WI
363LF0000X
Family Nurse Practitioner
450633
WI
363LF0000X
Family Nurse Practitioner
71008966A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100017022
WI
05
300025766
IN
Enumeration date
08/12/2011
Last updated
05/03/2023
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