Individual
KIM N LEDERHAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
740 DEERWOOD AVE, NEENAH, WI 54956-1601
(920) 751-9600
Mailing address
740 DEERWOOD AVE, NEENAH, WI 54956-1601
(920) 751-9600
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
131926
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245477801
—
WI
Enumeration date
01/19/2009
Last updated
03/13/2009
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