Provider Demographics
NPI:1851074405
Name:SALSIEDER, BRENNA (RN)
Entity Type:Individual
Prefix:
First Name:BRENNA
Middle Name:
Last Name:SALSIEDER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BRENNA
Other - Middle Name:
Other - Last Name:KRAMORIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:N75W22192 CHERRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:WI
Mailing Address - Zip Code:53089-2254
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:N75W22192 CHERRY HILL RD
Practice Address - Street 2:
Practice Address - City:SUSSEX
Practice Address - State:WI
Practice Address - Zip Code:53089-2254
Practice Address - Country:US
Practice Address - Phone:262-623-0825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI173243163W00000X
WI173243-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse