Provider Demographics
NPI:1083207781
Name:VOELTNER, LAURIE (RN)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:VOELTNER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:
Other - Last Name:MAAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:W165N10648 WAGON TRL
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53022-4159
Mailing Address - Country:US
Mailing Address - Phone:414-477-9555
Mailing Address - Fax:
Practice Address - Street 1:N27W23957 PAUL RD STE 100
Practice Address - Street 2:
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072-6223
Practice Address - Country:US
Practice Address - Phone:262-408-5873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI179090163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse