Provider Demographics
NPI:1891988960
Name:KRUPA, BRENDA (RN, MSN, PNP, APNP)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:
Last Name:KRUPA
Suffix:
Gender:F
Credentials:RN, MSN, PNP, APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 WATER AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:WI
Mailing Address - Zip Code:54634-9054
Mailing Address - Country:US
Mailing Address - Phone:608-489-8115
Mailing Address - Fax:608-489-8181
Practice Address - Street 1:400 WATER AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:WI
Practice Address - Zip Code:54634-9054
Practice Address - Country:US
Practice Address - Phone:608-489-8115
Practice Address - Fax:608-489-8181
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI53441-030163W00000X, 163WD0400X
WI3132-033363L00000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner