Most Relevant Information
Provider Data
| NPI Number: | 1003504200 |
| Provider Name: | MICHELLE DENISE BRANDENBURG |
| Entity Type: | Individual |
| Taxonomy Code: | 163WG0000X |
| Specialty: | Registered Nurse |
| License Number: | 1359172121 |
Most Important Dates
| Enumeration Date: | 04/26/2023 |
| Last Updated: | 04/26/2023 |
Provider Practice Location
5543 BELMONT DR
SHAWNEE
KS
662263623
Practice Location Phone/Fax
| Phone: | 9139638202 |
| Fax: |
Provider Mailing Location
5543 BELMONT DR
SHAWNEE
KS
662263623
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |