Healthcare Provider Details

I. General information

NPI: 1174458426
Provider Name (Legal Business Name): BRIANNA ROSE ROBINSON DR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

496 MILKY WAY
APPLETON WI
54915
US

IV. Provider business mailing address

1406 SALISBURY ST APT 8
GREEN BAY WI
54302-5423
US

V. Phone/Fax

Practice location:
  • Phone: 920-738-2681
  • Fax: 920-738-2685
Mailing address:
  • Phone: 920-738-2681
  • Fax: 920-738-2685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number17777-24
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: