Provider Demographics
NPI:1407046196
Name:AISPURO, KATHRYN J (RN, CNM)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:J
Last Name:AISPURO
Suffix:
Gender:F
Credentials:RN, CNM
Other - Prefix:MS
Other - First Name:KATHRYN
Other - Middle Name:J
Other - Last Name:LUEDTKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM, RN
Mailing Address - Street 1:11211 W LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53227-1035
Mailing Address - Country:US
Mailing Address - Phone:414-454-8300
Mailing Address - Fax:
Practice Address - Street 1:11211 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-1035
Practice Address - Country:US
Practice Address - Phone:414-454-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-28
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200541181RN163W00000X
OR200750139NP367A00000X
WI148919-32367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse