KARA L BROCHTRUP (NPI# 1467702241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467702241 |
| Entity Type | Individual |
| Full Name | KARA L BROCHTRUP |
| Credential | APNP |
| Practice Address |
2105 E. Enterprise Ave. Suite 111 Appleton WI 54913-7862 |
| Mailing Address |
2105 E Enterprise Ave. Suite 111 Appleton WI 54913-7862 |
| Practice Telephone | 9207316611 |
| Practice Fax Number | 9207316732 |
| Mailing Telephone | 9207316611 |
| Mailing Fax Number | 9207316732 |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2016-03-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 5040-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2105 E. ENTERPRISE AVE. SUITE 111 |
| City | APPLETON |
| State | WI |
| Zip Code | 54913-7862 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043254162 | Fvosa Surgical Partners, LLC | Clinic/Center | 2105 E. Enterprise Ave., Suite 101, Appleton, WI 54913 | 2006-06-16 |
| 1629218417 | Nicole E. Juedes | Specialist/Technologist, Other | 2105 E. Enterprise Ave., Suite 111, Appleton, WI 54913-7862 | 2009-03-06 |
| 1053578682 | Todd A Derksen | Podiatrist | 2105 E. Enterprise Ave., Suite 111, Appleton, WI 54913-7862 | 2008-05-21 |
| 1811179344 | Eric R. Bowen | Nurse Practitioner | 2105 E. Enterprise Ave., Suite 111, Appleton, WI 54913-7862 | 2007-11-27 |
| 1720023724 | Great Lakes Orthotics & Prosthetics Inc. | Prosthetic/Orthotic Supplier | 2105 E. Enterprise Ave., Suite 114, Appleton, WI 54913 | 2006-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457994584 | Pamela J Andersen | Music Therapist | 245 N. Metro Drive, Appleton, WI 54913 | 2019-10-22 |
| 1396387510 | Nancy Sibley | Technician | N4423 County Road Ee, Appleton, WI 54913 | 2019-10-09 |
| 1659872240 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 3801 N. Richmond Street, Grand Chute, WI 54913 | 2018-02-28 |
| 1780116244 | Alison Pelger | Physician Assistant | 3916 North Intertech Court, Appleton, WI 54913 | 2017-04-03 |
| 1316311905 | Lucy Bouressa | Specialist/Technologist | 2105 E. Enterprise Ave, 113, Appleton, WI 54913 | 2015-11-19 |
| 1992189989 | Brittany Reinke | Physical Therapist | Walking and Wheeling, LLC, W4652 Glenn Street, Appleton, WI 54913 | 2015-07-20 |
| 1902280092 | Costco Wholesale Corporation | Pharmacy | 5401 W Integrity Way, Grand Chute, WI 54913 | 2015-07-17 |
| 1942646849 | Richard Anthony Mauthe | Pharmacist | 5401 W. Integrity Way, Neenah, WI 54913 | 2013-05-17 |
| 1750622163 | Tonya Janelle Wilderman | Pharmacist | 1400 N Mccarthy Rd, Apt 2, Grand Chute, WI 54913 | 2013-03-10 |
| 1295938777 | Jenna Marie Kadlec | Physical Therapist | 3916 N. Intertech Court, Appleton, WI 54913 | 2007-06-11 |
| Find all providers in zip 54913 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477070308 | Tamara Marie A Marshall | Nurse Practitioner | 5605 W Waterford Ln, Appleton, WI 54913-8438 | 2017-08-22 |
| 1871748418 | Tammy E Weyenberg | Nurse Practitioner | 3962 N Richmond St, Appleton, WI 54913-7153 | 2008-11-24 |
| 1396802823 | Ellen Pitsch | Nurse Practitioner | 2809 N. Park Drive Lane, Appleton, WI 54911 | 2007-01-03 |
| 1629024823 | Deborah S Colon | Nurse Practitioner | 30 S Behl St, Appleton, MN 56208-1616 | 2006-05-26 |
| 1871541342 | Kimberly Williams | Nurse Practitioner | 1616 N Casaloma Dr Ste 100, Appleton, WI 54913-8245 | 2006-05-05 |
| 1659363778 | Pam E Verkuilen | Nurse Practitioner | 5320 W Michaels Drive, Appleton, WI 54913 | 2005-08-16 |
| 1053918524 | Nicole Anne Vannoie | Nurse Practitioner | 2500 E Capitol Dr, Appleton, WI 54911-8735 | 2020-10-07 |
| 1306454053 | Samantha L Thiede | Nurse Practitioner | 1818 N Meade St, Appleton, WI 54911-3454 | 2020-07-20 |
| 1215556824 | Cheryl E Christensen | Nurse Practitioner | 2500 E Capitol Dr, Appleton, WI 54911-8735 | 2020-04-14 |
| 1902467731 | Danielle L Leick | Nurse Practitioner | 1818 N Meade St, Appleton, WI 54911-3454 | 2019-06-24 |
| Find all providers in APPLETON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.