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NPI Code Detail

MEDICARE: MICHELLE BREGENZER APNP

MEDICARE:   MICHELLE  BREGENZER  APNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner209005840IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1364306053OTHERILTAX ID #

General Provider Information

NPI Number : 1861445546
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE BREGENZER APNP
Provider Business Mailing Address
First Line : 2520 ELISHA AVE
Second Line :
City : ZION
State : IL
Zip : 60099-2676
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3809 SPRING ST
Second Line :
City : MOUNT PLEASANT
State : WI
Zip : 53405-1667
Country : US
Telephone Number : 262-687-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2006
Last Update Date : 01/22/2024

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Directions to “ MICHELLE BREGENZER APNP” Practice Location

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