Healthcare Provider Details

I. General information

NPI: 1568256287
Provider Name (Legal Business Name): BRITTANY FREDERICK APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9555 76TH ST STE 4105
PLEASANT PRAIRIE WI
53158-1984
US

IV. Provider business mailing address

9555 76TH ST STE 4105
PLEASANT PRAIRIE WI
53158-1984
US

V. Phone/Fax

Practice location:
  • Phone: 262-577-8080
  • Fax: 262-577-8081
Mailing address:
  • Phone: 262-653-5483
  • Fax: 262-653-5850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number13949-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: