Provider Demographics
NPI:1518368299
Name:FIRKUS, LAURYN (APNP)
Entity Type:Individual
Prefix:MRS
First Name:LAURYN
Middle Name:
Last Name:FIRKUS
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:MS
Other - First Name:LAURYN
Other - Middle Name:
Other - Last Name:BERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1033 N MAYFAIR RD
Mailing Address - Street 2:SUITE # 101
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3442
Mailing Address - Country:US
Mailing Address - Phone:414-454-0600
Mailing Address - Fax:414-454-0971
Practice Address - Street 1:1033 N MAYFAIR RD
Practice Address - Street 2:SUITE # 101
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-3442
Practice Address - Country:US
Practice Address - Phone:414-454-0600
Practice Address - Fax:414-454-0971
Is Sole Proprietor?:No
Enumeration Date:2014-09-12
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5950-33363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health