Brockdorf, Kristen Jeanne

Brockdorf, Kristen Jeanne is an individual health care provider with primary practice located at 2500 E Capitol Dr , Appleton WI 54911-8735. She recently has 3 registered licenses in different health care specialties including Technologists, Technicians & Other Technical Service Providers / Medical Technologist, Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Brockdorf, Kristen Jeanne can be contacted via phone (920) 364-3600.

Contact Information

Primary practice address
2500 E Capitol Dr Appleton WI 54911-8735
Phone: (920) 364-3600
Fax: (920) 364-3900
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Medical Technologist 246QM0706X 249004 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 404123 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 404123 Wisconsin

Profile Details

NPI number 1558882555
LBN Legal business name Brockdorf, Kristen Jeanne
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2017
Last updated Sep 8th, 2022 - about 2 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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