1750892113 NPI number — MS. KAREN LYNN MOLITOR DNP, FNP, RN

Table of content: MS. KAREN LYNN MOLITOR DNP, FNP, RN (NPI 1750892113)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750892113 NPI number — MS. KAREN LYNN MOLITOR DNP, FNP, RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOLITOR
Provider First Name:
KAREN
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
DNP, FNP, RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHRISTENSEN
Provider Other First Name:
KAREN
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1750892113
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/24/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2600 N. MAYFAIR RD. METROPOLITAN UROLOGY
Provider Second Line Business Mailing Address:
SUITE 545
Provider Business Mailing Address City Name:
WAUWATOSA
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53226
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
414-476-0430
Provider Business Mailing Address Fax Number:
414-476-3242

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2600 N. MAYFAIR RD. METROPOLITAN UROLOGY
Provider Second Line Business Practice Location Address:
SUITE 545
Provider Business Practice Location Address City Name:
WAUWATOSA
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53226
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-476-0430
Provider Business Practice Location Address Fax Number:
414-476-3242
Provider Enumeration Date:
10/12/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  8087 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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