Provider Demographics
NPI:1548214133
Name:HYLKEMA, LORRIE W (RN, CS, APNP)
Entity Type:Individual
Prefix:MRS
First Name:LORRIE
Middle Name:W
Last Name:HYLKEMA
Suffix:
Gender:F
Credentials:RN, CS, APNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:438 TOEPFER AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-1660
Mailing Address - Country:US
Mailing Address - Phone:608-233-7103
Mailing Address - Fax:608-233-7103
Practice Address - Street 1:306 N BROOKS ST
Practice Address - Street 2:VA CSP
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-1002
Practice Address - Country:US
Practice Address - Phone:608-280-7195
Practice Address - Fax:608-256-0743
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1857-033364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult