Healthcare Provider Details

I. General information

NPI: 1952830499
Provider Name (Legal Business Name): BRITNEY ANN WENIG DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS BRITNEY ANN ROBERTS

II. Dates (important events)

Enumeration Date: 06/08/2017
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3113 SAEMANN AVE
SHEBOYGAN WI
53081-1957
US

IV. Provider business mailing address

PO BOX 19070
GREEN BAY WI
54307-9070
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number5901400395
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number1323-25
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number07001327A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: