Provider Demographics
NPI:1659390896
Name:LAPP, JANINE MARIE (APNP)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:MARIE
Last Name:LAPP
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2514 S 102ND ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53227-2142
Mailing Address - Country:US
Mailing Address - Phone:414-777-5200
Mailing Address - Fax:414-777-5210
Practice Address - Street 1:5650 N GREEN BAY AVE STE 100
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53209-4447
Practice Address - Country:US
Practice Address - Phone:414-431-5971
Practice Address - Fax:414-434-0354
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1559363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43911800Medicaid
WI43911800Medicaid
001101079Medicare PIN