Provider Demographics
NPI:1619046794
Name:BRENSINGER, JOHN FRANKLIN IV (LPN)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:FRANKLIN
Last Name:BRENSINGER
Suffix:IV
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W2147 STATE ROAD 11
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:WI
Mailing Address - Zip Code:53121-4156
Mailing Address - Country:US
Mailing Address - Phone:262-903-6114
Mailing Address - Fax:
Practice Address - Street 1:W2147 STATE ROAD 11
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:WI
Practice Address - Zip Code:53121-4156
Practice Address - Country:US
Practice Address - Phone:262-903-6114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse