Individual
LAURA CM KIRKEGAARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1100 GATEWAY CT, WEST BEND, WI 53095-8539
(262) 335-8600
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1110-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43893200
—
WI
01
—
P00934576
RR MEDICARE
WI
Enumeration date
07/31/2006
Last updated
11/06/2023
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