Individual
BRILLIANT GLORY NIMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2561 N 29TH ST, MILWAUKEE, WI 53210-3116
(414) 264-5338
(414) 264-5625
Mailing address
9000 W WISCONSIN AVE, MS 958, MILWAUKEE, WI 53226-4874
(414) 266-7615
(414) 266-6238
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
64290-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982047411
—
WI
Enumeration date
04/15/2013
Last updated
07/14/2016
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