Provider Demographics
NPI:1336483726
Name:KARTMAN, LORI LYNN
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:LYNN
Last Name:KARTMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 2ND ST
Mailing Address - Street 2:
Mailing Address - City:FENNIMORE
Mailing Address - State:WI
Mailing Address - Zip Code:53809-1004
Mailing Address - Country:US
Mailing Address - Phone:608-778-1169
Mailing Address - Fax:
Practice Address - Street 1:1509 2ND ST
Practice Address - Street 2:
Practice Address - City:FENNIMORE
Practice Address - State:WI
Practice Address - Zip Code:53809-1004
Practice Address - Country:US
Practice Address - Phone:608-778-1169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI303853-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse