Provider Demographics
NPI:1780635151
Name:BROSNAN SCHULER, THERESA (NP)
Entity Type:Individual
Prefix:MS
First Name:THERESA
Middle Name:
Last Name:BROSNAN SCHULER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:THERESA
Other - Middle Name:
Other - Last Name:BROSNAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2920 SUPERIOR AVE
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-1944
Mailing Address - Country:US
Mailing Address - Phone:920-452-6000
Mailing Address - Fax:920-458-3420
Practice Address - Street 1:2920 SUPERIOR AVE
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-1944
Practice Address - Country:US
Practice Address - Phone:920-452-6000
Practice Address - Fax:920-458-3420
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI131044363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q00400Medicare UPIN
0087P73601Medicare ID - Type Unspecified