Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kristen Jeanne Brockdorf, PA-C

Individual provider Medical Technologist · NPI 1558882555

Kristen Jeanne Brockdorf, PA-C is a Physician Assistant in Appleton, Wisconsin. Qualified in 2017, 9 years ago. Practices with Thedacare, Incorporated, a 654-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
9
Licensed in
WI
In the registry since
2017
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

2500 E Capitol Dr
Appleton, WI 54911-8735
Phone: (920) 364-3600
Fax: (920) 364-3900
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1818 N Meade St, Appleton, WI 54911-3454 — (920) 731-4101
  • 130 2nd St, Neenah, WI 54956-2883 — (920) 729-3100

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 404123 (WI)
Medical Technologist Taxonomy 246QM0706X · Licence 249004 (WI)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 404123 (WI)

Record details

NPI number1558882555
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 29, 2017
Last updated in NPPESSeptember 8, 2022
Certification dateSeptember 8, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Thedacare, Incorporated — 654 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare