Nina Sebastian Bredehorn, MSN, APNP, CPNP, PMH

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

4971-33 Issued in WI

Practice address

10303 N Port Washington Rd
Suite 203
Mequon, WI 53092-5760

Phone

(262) 241-5955

Fax

(262) 241-5926

NPI assigned

Sep 13, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Master of Science - Nursing

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Collaborative Solutions in Psychiatry, SC

  • Psychiatry Physician
  • Madison, WI
  • NPI 1619352226
  NPD (past)
• Dr. Kirmani-Moe, LLC

  • Community/Behavioral Health Agency
  • Madison, WI
  • NPI 1952790107
  NPD (past)
• North Shore Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mequon, WI
  • NPI 1780755389
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1144570433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 E HARRISON ST",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539251510",
            "telephone_number": "262-241-5955",
            "fax_number": "262-241-5926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10303 N PORT WASHINGTON RD",
            "address_2": "SUITE 203",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925760",
            "telephone_number": "262-241-5955",
            "fax_number": "262-241-5926"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7818 Big Sky Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537192840",
            "country_code": "US",
            "telephone_number": "608-203-6267",
            "fax_number": "608-203-6696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREDEHORN",
        "first_name": "NINA",
        "middle_name": "SEBASTIAN",
        "credential": "MSN, APNP, CPNP, PMH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "WI",
            "license": "170295-30",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "4971-33",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WI",
            "license": "4971-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brain Balance Center of Mequon
• Allison Braithwaite
• Katelyn Brandt
• Jenna Branovan
• Michael Braun, M.D.
• Donna J Brehm, M.D.
• Marcie Brenner, PT
• Brent J Martin DDS Ms SC
• Brett Egelseer
• Brewer Counseling and Wellness

• Pediatric Nurse Practitioner in Mequon, WI
• Providers in Mequon, WI by specialty
• Pediatric Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.