Individual
KIMBERLY ANN LAGROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N., FNP-C
Contact information
Practice address
W125S6729 JO CT, MUSKEGO, WI 53150-3512
(262) 893-2645
Mailing address
W125S6729 JO CT, MUSKEGO, WI 53150-3512
(262) 893-2645
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
130133-030
WI
163WH0200X
Home Health Registered Nurse
130133-030
WI
363LF0000X
Family Nurse Practitioner
Primary
7506
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39912500
—
WI
Enumeration date
01/16/2007
Last updated
02/02/2017
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