Provider Demographics
NPI:1952830499
Name:WENIG, BRITNEY ANN (DPM)
Entity type:Individual
Prefix:DR
First Name:BRITNEY
Middle Name:ANN
Last Name:WENIG
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:MISS
Other - First Name:BRITNEY
Other - Middle Name:ANN
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 19070
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54307-9070
Mailing Address - Country:US
Mailing Address - Phone:920-496-4700
Mailing Address - Fax:
Practice Address - Street 1:3113 SAEMANN AVE
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-1957
Practice Address - Country:US
Practice Address - Phone:920-496-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901400395213ES0103X
WI1323-25213ES0103X
IN07001327A213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN07001327AOtherINDIANA PROFESSIONAL LICENSING
WI100282344Medicaid
MI5315224030OtherCSR
MI5901400395OtherMICHIGAN PROFESSIONAL LICENSE
IN07001327BOtherCSR - PODIATRIST
INFW9011355OtherDEA