Provider Demographics
NPI:1669187951
Name:BRETL, SHEENA (NP)
Entity type:Individual
Prefix:
First Name:SHEENA
Middle Name:
Last Name:BRETL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207256 PINERY RD
Mailing Address - Street 2:
Mailing Address - City:HATLEY
Mailing Address - State:WI
Mailing Address - Zip Code:54440-5181
Mailing Address - Country:US
Mailing Address - Phone:715-630-0262
Mailing Address - Fax:
Practice Address - Street 1:2405 SCHOFIELD AVE STE 130
Practice Address - Street 2:
Practice Address - City:SCHOFIELD
Practice Address - State:WI
Practice Address - Zip Code:54476-6421
Practice Address - Country:US
Practice Address - Phone:614-500-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13506-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily