Individual
KAITLYN BRENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3500 TOWER AVE, SUPERIOR, WI 54880-4491
(715) 817-7100
(715) 817-7039
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-4999
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2348
MN
363A00000X
Physician Assistant
7142
WI
Other
Enumeration date
10/13/2015
Last updated
12/21/2022
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