Provider Demographics
NPI:1528020054
Name:FRITSCHE, LAURA HOYT (LPN)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:HOYT
Last Name:FRITSCHE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1622 110TH AVE
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:WI
Mailing Address - Zip Code:54015-4801
Mailing Address - Country:US
Mailing Address - Phone:715-796-2617
Mailing Address - Fax:
Practice Address - Street 1:1232 6TH ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-1342
Practice Address - Country:US
Practice Address - Phone:715-386-3415
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI18788-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38263900Medicaid