Provider Demographics
NPI:1710506696
Name:BERENS, BRITTANY N (PA-C)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:N
Last Name:BERENS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5793 W LAKE DR
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-8447
Mailing Address - Country:US
Mailing Address - Phone:920-210-0433
Mailing Address - Fax:
Practice Address - Street 1:901 MCCLINTOCK DR
Practice Address - Street 2:
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-0871
Practice Address - Country:US
Practice Address - Phone:888-220-6432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-10
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant