Healthcare Provider Details

I. General information

NPI: 1194352716
Provider Name (Legal Business Name): MARIE BRICK APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

906 N CENTER AVE
MERRILL WI
54452-1244
US

IV. Provider business mailing address

906 N CENTER AVE
MERRILL WI
54452-1244
US

V. Phone/Fax

Practice location:
  • Phone: 715-722-0003
  • Fax:
Mailing address:
  • Phone: 715-722-0003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number138888-30
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12157-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: