Healthcare Provider Details

I. General information

NPI: 1326525049
Provider Name (Legal Business Name): BRITTANY WALCZYK DNP, APNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2018
Last Update Date: 03/22/2024
Certification Date: 03/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 EXECUTIVE DRIVE
GREEN BAY WI
54307
US

IV. Provider business mailing address

1118 S NEENAH AVE
STURGEON BAY WI
54235
US

V. Phone/Fax

Practice location:
  • Phone: 920-746-5093
  • Fax:
Mailing address:
  • Phone: 920-496-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number196513
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number8535
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code363LS0200X
TaxonomySchool Nurse Practitioner
License Number196513
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number196513
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: