Boettcher, Bradley J

Boettcher, Bradley J is an individual health care provider with primary practice located at 744 S Webster Ave , Green Bay WI 54301-3505. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, Nursing Service Providers / Registered Nurse. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Boettcher, Bradley J can be contacted via phone (920) 445-7222.

Contact Information

Primary practice address
744 S Webster Ave Green Bay WI 54301-3505
Phone: (920) 445-7222
Fax: (920) 445-7289
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 3411 Wisconsin
Nursing Service Providers / Registered Nurse 163W00000X 141347 Wisconsin

Profile Details

NPI number 1295906675
LBN Legal business name Boettcher, Bradley J
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 13th, 2008
Last updated Nov 1st, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295906675 NPPES
Wisconsin Other 141347 RN SECONDARY WI STATE LICENSE
Wisconsin Other 3411 RN SECONDARY WI STATE LICENSE

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