Individual
KIMBERLY J LORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-5000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2913
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36010900
—
WI
Enumeration date
09/21/2006
Last updated
08/28/2024
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