Provider Demographics
NPI:1477986388
Name:HAUSSERMANN, BRENDA RENEE (APRN)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:RENEE
Last Name:HAUSSERMANN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1313 N CHEYENNE ST
Mailing Address - Street 2:PO BOX 626
Mailing Address - City:BENKELMAN
Mailing Address - State:NE
Mailing Address - Zip Code:69021-3074
Mailing Address - Country:US
Mailing Address - Phone:308-423-2204
Mailing Address - Fax:308-423-5691
Practice Address - Street 1:720 N WEBB RD
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-3310
Practice Address - Country:US
Practice Address - Phone:308-395-7700
Practice Address - Fax:308-395-7713
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE111571363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily