Provider Demographics
NPI:1205498680
Name:MICHELS, BRANDEE L (FNP)
Entity type:Individual
Prefix:MRS
First Name:BRANDEE
Middle Name:L
Last Name:MICHELS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOMIRA
Mailing Address - State:WI
Mailing Address - Zip Code:53048-9515
Mailing Address - Country:US
Mailing Address - Phone:262-339-1264
Mailing Address - Fax:
Practice Address - Street 1:1041 MAIN ST
Practice Address - Street 2:
Practice Address - City:LOMIRA
Practice Address - State:WI
Practice Address - Zip Code:53048-9515
Practice Address - Country:US
Practice Address - Phone:262-339-1264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-05
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9307363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily