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NPI Code Detail

MEDICARE: BREANN A VUCSKO RN

MEDICARE: BREANN A VUCSKO RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WC0400XCase Management Registered Nurse041376596IL

General Provider Information

NPI Number : 1417888330
Entity Type Code : Individual
Provider Name (Legal Business Name) : BREANN A VUCSKO RN
Provider Business Mailing Address
First Line : 6148 N GERMAN CHURCH RD
Second Line :
City : BYRON
State : IL
Zip : 61010-9733
Country : US
Telephone Number : 608-280-7003
Fax Number : 608-280-7242
Provider Business Practice Location Address
First Line : 2500 OVERLOOK TER
Second Line :
City : MADISON
State : WI
Zip : 53705-2254
Country : US
Telephone Number : 608-280-7003
Fax Number : 608-280-7242
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2026
Last Update Date : 05/28/2026

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