| Doctor Name: | MRS. BRENDA RENEE MORTENSEN |
| NPI Number: | 1174878326 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N. |
| License Number: | 189634-30 |
| Business Practice Address: | 121 Maple St Edgerton, WI - 535349332 |
| Business Phone Number: | 6088843999 |
| Business Fax Number: | |
| Mailing Address: | 121 Maple St, EDGERTON |
| State: | WI |
| Postal Code: | 535349332 |
| Phone Number: | 6088843999 |
| Fax Number: | |
| NPI Enumeration Date: | 07/13/2012 |
| NPI Last Update Date: | 07/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WH0200X |
| License Number: | 189634-30 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Home Health |
| Taxonomy Definition: | |