Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 11325-33 | WI |
NPI | 1457014607 |
---|---|
Provider Name | Michelle Marie Breininger |
First Address | Wauwatosa, WI 53213-2930 |
Second Address | Menomonee Falls, WI 53051-3518 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2021 |
Last Update Date | 14/10/2021 |