Provider Demographics
NPI:1265276125
Name:BRETZEL, CIERRIA VICTORIA (DNP)
Entity type:Individual
Prefix:
First Name:CIERRIA
Middle Name:VICTORIA
Last Name:BRETZEL
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 VALLEY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:WAUTOMA
Mailing Address - State:WI
Mailing Address - Zip Code:54982-9592
Mailing Address - Country:US
Mailing Address - Phone:920-240-7795
Mailing Address - Fax:
Practice Address - Street 1:1006 COUNTY ROAD EE
Practice Address - Street 2:
Practice Address - City:REDGRANITE
Practice Address - State:WI
Practice Address - Zip Code:54970-9575
Practice Address - Country:US
Practice Address - Phone:920-566-3167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15440-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily