Provider Demographics
NPI:1629435193
Name:BREHMER, ROZANNE (RN)
Entity Type:Individual
Prefix:
First Name:ROZANNE
Middle Name:
Last Name:BREHMER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8253 DEMUTH LN
Mailing Address - Street 2:
Mailing Address - City:OCONTO FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54154-9750
Mailing Address - Country:US
Mailing Address - Phone:920-373-5738
Mailing Address - Fax:
Practice Address - Street 1:8253 DEMUTH LN
Practice Address - Street 2:
Practice Address - City:OCONTO FALLS
Practice Address - State:WI
Practice Address - Zip Code:54154-9750
Practice Address - Country:US
Practice Address - Phone:920-373-5738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-28
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10483330163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse