Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 6350-33 | WI |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 6350-33 | WI |
NPI | 1053798918 |
---|---|
Provider Name | Kyle S Paulsen |
First Address | Franklin, WI 53132-8040 |
Second Address | Milwaukee, WI 53215-3677 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2015 |
Last Update Date | 30/11/2021 |