Active NPI
Brigitte Elise Wittenberger, LPN
- Licensed Practical Nurse
- Mayville, WI
National Provider Identifier
1003171802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 309698-31
- Practice address
- 318 Brookside Dr Unit 6
Mayville, WI 53050-2847 - Phone
- (920) 214-3423
- NPI assigned
- Jul 8, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 309698-31 | WI | Primary |
Addresses
Primary practice location
318 Brookside Dr Unit 6
Mayville, WI 53050-2847
Mailing address
318 Brookside Dr Unit 6
Mayville, WI 53050-2847
Phone (920) 214-3423
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 309698-31 | Other | WI | NURSING LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 309698-31 | WI | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341705600000",
"number": "1003171802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "318 BROOKSIDE DR UNIT 6",
"city": "MAYVILLE",
"state": "WI",
"postal_code": "530502847",
"telephone_number": "920-214-3423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "318 BROOKSIDE DR UNIT 6",
"city": "MAYVILLE",
"state": "WI",
"postal_code": "530502847",
"telephone_number": "920-214-3423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITTENBERGER",
"first_name": "BRIGITTE",
"middle_name": "ELISE",
"name_prefix": "Mrs.",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-07-08",
"last_updated": "2012-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "WI",
"license": "309698-31",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NURSING LICENSE",
"identifier": "309698-31",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mayville, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.