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Individual

CAROLINE MARIE BRANDT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGACNP-BC

Contact information

Practice address
975 PORT WASHINGTON RD STE 310, GRAFTON, WI 53024
(262) 329-1000
(262) 329-8151
Mailing address
975 PORT WASHINGTON RD STE 310, GRAFTON, WI 53024-9201
(262) 329-1000
(262) 329-8151

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8052
WI
363LA2100X
Acute Care Nurse Practitioner
8052-33
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1992215867
WI
Enumeration date
10/05/2017
Last updated
10/23/2018
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