Individual
BRENDA M VELDBOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
110 BUTLER ST, RANDOM LAKE, WI 53075-1708
(920) 994-9094
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3202-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007004590
ANCC
WI
05
—
36042200
—
WI
Enumeration date
09/06/2007
Last updated
09/16/2025
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