Provider Demographics
NPI:1255329835
Name:LAABS, CAROLYN ANN (NP)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ANN
Last Name:LAABS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53233-1411
Mailing Address - Country:US
Mailing Address - Phone:414-765-0606
Mailing Address - Fax:414-765-0226
Practice Address - Street 1:1027 N 9TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53233-1411
Practice Address - Country:US
Practice Address - Phone:414-765-0606
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-08
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI70053-030363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily