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Individual

KRISTEN MARY LUIKART

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
2021 S WEBSTER AVE, ALLOUEZ, WI 54301-2257
(920) 965-0345
Mailing address
2021 S WEBSTER AVE, ALLOUEZ, WI 54301-2257
(920) 965-0345

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3113-23
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
748440000
MN
01
P00468513
RAILROAD MEDICARE
MN
Enumeration date
07/24/2007
Last updated
01/02/2015
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