Provider Demographics
NPI:1558711283
Name:VANDER ZANDEN, BRIANNA RAE (APNP)
Entity Type:Individual
Prefix:MRS
First Name:BRIANNA
Middle Name:RAE
Last Name:VANDER ZANDEN
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:RAE
Other - Last Name:SCHLIEVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 8003
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54912-8003
Mailing Address - Country:US
Mailing Address - Phone:920-996-3200
Mailing Address - Fax:920-738-5787
Practice Address - Street 1:2500 E CAPITOL DR
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-8735
Practice Address - Country:US
Practice Address - Phone:920-738-4600
Practice Address - Fax:920-738-4792
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6995363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner