Provider Demographics
NPI:1891458105
Name:SIERRA, BRDGET (APNP)
Entity Type:Individual
Prefix:
First Name:BRDGET
Middle Name:
Last Name:SIERRA
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3520 NASSAU DR
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-2013
Mailing Address - Country:US
Mailing Address - Phone:440-308-6962
Mailing Address - Fax:
Practice Address - Street 1:3520 NASSAU DR
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-2013
Practice Address - Country:US
Practice Address - Phone:440-308-6962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11329363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner