Individual
KIMBERLY ANN CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
945 N 12TH ST, MILWAUKEE, WI 53233-1305
(414) 219-2000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5480
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100174293
—
WI
Enumeration date
03/10/2021
Last updated
05/16/2025
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