Provider Demographics
NPI:1447565379
Name:FELDBRUEGGE, MATTHEW J (APNP)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:J
Last Name:FELDBRUEGGE
Suffix:
Gender:M
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1186 APPLETON RD
Mailing Address - Street 2:
Mailing Address - City:MENASHA
Mailing Address - State:WI
Mailing Address - Zip Code:54952-1906
Mailing Address - Country:US
Mailing Address - Phone:920-727-8700
Mailing Address - Fax:920-787-8740
Practice Address - Street 1:1186 APPLETON RD
Practice Address - Street 2:
Practice Address - City:MENASHA
Practice Address - State:WI
Practice Address - Zip Code:54952-1906
Practice Address - Country:US
Practice Address - Phone:920-727-8700
Practice Address - Fax:920-787-8740
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4127363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily