Provider Demographics
NPI:1225332869
Name:KALKOPF, DAWN MARIE (LPN)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:MARIE
Last Name:KALKOPF
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:S22 W 36041 COUNTRY MEADOW CT.
Mailing Address - Street 2:
Mailing Address - City:DOUSMAN
Mailing Address - State:WI
Mailing Address - Zip Code:53118-9689
Mailing Address - Country:US
Mailing Address - Phone:262-391-9492
Mailing Address - Fax:
Practice Address - Street 1:S22 W 36041 COUNTRY MEADOW CT.
Practice Address - Street 2:
Practice Address - City:DOUSMAN
Practice Address - State:WI
Practice Address - Zip Code:53118-9689
Practice Address - Country:US
Practice Address - Phone:262-391-9492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-22
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI306587-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse