Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 76022 | WI |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 76022 | WI |
NPI | 1215375027 |
---|---|
Provider Name | Dr. Jennifer Danielle Bruening |
First Address | Milwaukee, WI 53212-3220 |
Second Address | Milwaukee, WI 53226-3522 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2013 |
Last Update Date | 15/09/2021 |