Brenda Renee Mortensen, R.N.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

189634-30 Issued in WI

Practice address

121 Maple St
Edgerton, WI 53534-9332

Phone

(608) 884-3999

NPI assigned

Jul 13, 2012

Last updated

Jul 13, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Brenda Renee Lowell Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342137600000",
    "number": "1174878326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 MAPLE ST",
            "city": "EDGERTON",
            "state": "WI",
            "postal_code": "535349332",
            "telephone_number": "608-884-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 MAPLE ST",
            "city": "EDGERTON",
            "state": "WI",
            "postal_code": "535349332",
            "telephone_number": "608-884-3999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSEN",
        "first_name": "BRENDA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-13",
        "last_updated": "2012-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "189634-30",
            "primary": true
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WI",
            "license": "189634-30",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "LOWELL",
            "middle_name": "RENEE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amy D. Millard, NP
• Robert Newell Miller IV, MD
• Milton & Edgerton Vision Centers, LLC (Edgerton Vision Center)
• Anna Mirkes
• Jenna Morse, OT
• Joshua A Mou, MD
• Ravi Murali, M.D
• David Nottelson
• Lars Christian Olstad
• Adam Paljieg, DPT

• Registered Nurse in Edgerton, WI
• Providers in Edgerton, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.

Verify at the official NPI Registry.