Provider Demographics
NPI:1154780922
Name:BURG, BRITTANY R (NP)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:R
Last Name:BURG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:R
Other - Last Name:ECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:122 E COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-5741
Mailing Address - Country:US
Mailing Address - Phone:920-996-3264
Mailing Address - Fax:920-830-5970
Practice Address - Street 1:130 2ND ST
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-2883
Practice Address - Country:US
Practice Address - Phone:920-729-2030
Practice Address - Fax:920-729-9384
Is Sole Proprietor?:No
Enumeration Date:2016-02-22
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI189748363L00000X
WI6860363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner