Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 2786-33 | WI |
N | 363LG0600X | Nurse Practitioner - Gerontology | 0208183 | WI |
NPI | 1083681332 |
---|---|
Provider Name | Kristen E Lachapell |
First Address | Troy, MI 48099-1239 |
Second Address | Mequon, WI 53092-1855 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2006 |
Last Update Date | 01/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
41279500 | (05) | WI |