Individual
JEREMY L KAUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
3224 KENNSINGTON SQUARE RD, STURTEVANT, WI 53177-2821
(262) 762-9284
(262) 419-3818
Mailing address
212 4TH ST, RACINE, WI 53403-1005
(262) 206-0412
(262) 419-3818
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
13690-33
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
13690-33
WI
Other
Enumeration date
03/07/2023
Last updated
02/05/2025
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