Kelly L Brendel, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5946 Issued in WI

Practice address

W571 County Road L
East Troy, WI 53120-2408

Phone

(815) 222-1641

NPI assigned

Jun 10, 2014

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1407269236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W571 COUNTY ROAD L",
            "city": "EAST TROY",
            "state": "WI",
            "postal_code": "531202408",
            "telephone_number": "815-222-1641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W571 COUNTY ROAD L",
            "city": "EAST TROY",
            "state": "WI",
            "postal_code": "531202408",
            "telephone_number": "815-222-1641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 W Blackhawk Dr",
            "address_purpose": "LOCATION",
            "city": "Byron",
            "state": "IL",
            "postal_code": "610108988",
            "country_code": "US",
            "telephone_number": "779-696-1300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 W Blackhawk Dr",
            "address_purpose": "LOCATION",
            "city": "Byron",
            "state": "IL",
            "postal_code": "610108988",
            "country_code": "US",
            "telephone_number": "779-696-1300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRENDEL",
        "first_name": "KELLY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-10",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "5946",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "19854730",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209-011771",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in East Troy, WI
• Providers in East Troy, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.