Individual
NICOLE LAABS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2555 N MARTIN LUTHER KING DR, MILWAUKEE, WI 53212-2709
(414) 267-2080
(414) 267-8570
Mailing address
2555 N MARTIN LUTHER KING DR, MILWAUKEE, WI 53212-2709
(414) 267-2080
(414) 267-8570
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2677-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K400308317
MEDICARE PTAN
WI
Enumeration date
10/01/2010
Last updated
11/08/2016
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