Provider Demographics
NPI:1346486768
Name:MESENBRINK, LAURA LOU (APNP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:LOU
Last Name:MESENBRINK
Suffix:
Gender:F
Credentials:APNP
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Other - Last Name:
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Mailing Address - Street 1:2400 W VILLARD AVE
Mailing Address - Street 2:WFHC GLENDALE FAMILY CENTER
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-4901
Mailing Address - Country:US
Mailing Address - Phone:414-527-8348
Mailing Address - Fax:414-527-8046
Practice Address - Street 1:2400 W VILLARD AVE
Practice Address - Street 2:WFHC GLENDALE FAMILY CENTER
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53209-4901
Practice Address - Country:US
Practice Address - Phone:414-527-8348
Practice Address - Fax:414-527-8046
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3624-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1346486768Medicaid
WI73601 1793Medicare PIN