Provider Demographics
NPI:1912026386
Name:LITWACK, KIM (NP)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:
Last Name:LITWACK
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Gender:F
Credentials:NP
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Mailing Address - Street 1:4131 W LOOMIS RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53221-2051
Mailing Address - Country:US
Mailing Address - Phone:414-325-7246
Mailing Address - Fax:414-325-3770
Practice Address - Street 1:34 SCHROEDER CT
Practice Address - Street 2:SUITE 100
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-2525
Practice Address - Country:US
Practice Address - Phone:608-288-7246
Practice Address - Fax:608-288-7999
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2011-05-27
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Provider Licenses
StateLicense IDTaxonomies
WI2411363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner