Individual
LAURA E BALLWEG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
2825 HUNTERS TRL, PORTAGE, WI 53901-3429
(608) 742-7161
(608) 745-3990
Mailing address
2825 HUNTERS TRL, PORTAGE, WI 53901-3429
(608) 742-7161
(608) 745-3990
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6931-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770938771
—
WI
01
—
P01729173
RAILROAD MEDICARE
WI
Enumeration date
04/27/2016
Last updated
11/23/2016
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