Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 74004-20 | WI |
N | 207SG0201X | Clinical Genetics (M.D.) | 0101265711 | VA |
N | 207SG0201X | Clinical Genetics (M.D.) | D86392 | MD |
N | 207SG0201X | Clinical Genetics (M.D.) | MD046695 | DC |
NPI | 1629063334 |
---|---|
Provider Name | Kim Keppler-Noreuil |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53705-2274 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2005 |
Last Update Date | 09/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
54588 | WELLMARK BCBS (01) | IA |
F56967 | (02) |