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NPI Code Detail

MEDICARE: BRENDA RENEE HAUSSERMANN APRN

MEDICARE: BRENDA RENEE HAUSSERMANN APRN
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
1363LF0000XFamily Nurse Practitioner111571NE

General Provider Information

NPI Number : 1477986388
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA RENEE HAUSSERMANN APRN
Provider Business Mailing Address
First Line : 1313 N CHEYENNE ST
Second Line : PO BOX 626
City : BENKELMAN
State : NE
Zip : 69021-3074
Country : US
Telephone Number : 308-423-2204
Fax Number : 308-423-5691
Provider Business Practice Location Address
First Line : 720 N WEBB RD
Second Line :
City : GRAND ISLAND
State : NE
Zip : 68803-3310
Country : US
Telephone Number : 308-395-7700
Fax Number : 308-395-7713
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2013
Last Update Date : 07/05/2023

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